Skip to main content

Full text of "Lectures on materia medica"

See other formats


//7 7y/)t!\ 

■ f v o » / ™ I 



LECTURES 



ON 



MATERIA MEDICA. 



BY 

CARROLL DUNHAM, M. D. 

'j'l'HOS OF -, HOMCEOPA.THY THE SCIENCE OF THERAPEUTICS." ETC 



PHILADELPHIA : 

F. E. BOERICKE, 

HAHNEMANN PUBLISHING HOUSE. 
1884. 




Entered, according to Act of Congress, in the year 1870, 
By Carroll Dunham, Jr., 
In the Office of the Librarian of Congress, at Washington. 



CONTENTS. 



Page. 

Preface v 

Memoir of the Author, by e. m. Kellogg, m. d. vii 

I. Materia Medica and Therapeutics i 

II. Study of Materia Medica 19 

III. The Therapeutic Law 39 

IV. Preliminary Observations 61 

V. Aconitum Napellus 66 

VI. Bryonia Alba 89 

VII. EUPATORIUM 115 

VIII. Rhus Toxicodendron 121 

IX. Colchicum 157 

X. Ledum Palustre 173 

XI. Rhododendron Chrysanthum 182 

XII. Kalmia Latifolia 187 

XIII. Spigelia Anthelmia 196 

XIV. Atropa Belladonna 213 

XV. Hyoscyamus Niger 278 

XVI. Datura Stramonium 288 

XVII. Opium 301 

XVIII. Helleborus Niger 3" 

XIX. Silicea 316 

XX. Strychnos Nux Vomica 349 

XXI. Aloes 366 

XXII. Sulphur 381 

XXIII. Graphites 393 

XXIV. Lachesis 4° r 



PREFACE, 



THE lectures contained in these volumes were 
delivered by Dr. Dunham while he occupied 
the chair of Materia Medica in the New- York 
Homoeopathic Medical College. 

They have been edited from his note-books, 
practically verbatim, and are the ripe fruit of his 
thought and experience, — in his own latest words, 
" too valuable to be lost." 

His wife, now also deceased, made arrange- 
ments for their publication, hoping thereby to 
render his labors more available to the profession, 
and thus promote a chief object of his life, — the 
benefit of his fellow-men through the development 
and dissemination of a rational and scientific Thera- 
peutics. 

IRVINGTON-ON-HUDSON, Aug. 27, 1 8/8. 



MEMOIR OF THE AUTHOR. 



"His life was gentle; and the elements 
So mixed in him, that Nature might stand up 
And say to all the world — this was a man!" 




HE memory of this great and good man is enshrined 



X hi the work he accomplished on earth, as well as 
in the hearts of all who came within the circle of his 
wise and helpful benevolence. 

" Si monumentum quaeris, circumspice ! " Although 
no words can enrich such a record, they may serve, even 
in a fragmentary review, to present the leading traits of 
this noble life with sufficient distinctness for profitable 
study. 

Carroll Dunham was the youngest of four sons of 
Edward Wood Dunham and Maria Smyth Parker, and 
was born in the city of New- York, October 29, 1828. 
The families of both parents were old and prominent 
residents of New Brunswick, in the State of New Jersey. 
Mr. Dunham was for many years a successful merchant, 
and was distinguished for his intelligence, energy, probity 
and methodical habits of business. About the year 1820 
he removed with his family from New Brunswick to New 
York, and in 1853 he retired from business with an 
ample fortune, honorably acquired He soon afterward 



viii 



MEMOIR OF THE AUTHOR. 



became president of the Corn Exchange Bank, which 
position he retained until his death. His wife was a lady 
whose character happily combined gentleness with pru- 
dence and firmness ; qualities which her son Carroll 
seems to have inherited along with the business aptitude, 
energy and uprightness of his father. Mrs. Dunham died 
during the cholera epidemic of 1832, when Carroll was 
but four years old. 

Those who remember Carroll Dunham as a boy, 
speak of him as remarkably docile, bright and cheerful, 
and considerate of the feelings of others. His general 
health was good, but he usually avoided the rough sports 
of his companions. " He was always," says one of his 
elder brothers, " looking into things, with an eager desire 
to know all about their qualities and uses." As a youth 
he was affectionate, truthful and energetic, more fond of 
books than play ; and even at that time, his demeanor 
toward his fellows was marked by that same modest 
reserve — far removed from timidity — which was a prom- 
inent characteristic throughout his whole life. 

He entered Columbia College in 1843, and graduated 
with honor in 1847. Immediately afterward, he com- 
menced the study of medicine under Dr. Whittaker, an 
old-school practitioner, very capable, and at that time of 
high repute as a trainer of students. In 1850 he received 
his degree of M. D. from the College of Physicians and 
Surgeons of New- York, then located in Crosby street. 
His previous mental training, as well as his greater natu- 
ral ability, enabled him, during his student life, to outstrip 
his fellows ; and the cheerful readiness and patience with 
which he smoothed the difficulties of those who sought 
his aid soon drew around him a select number of fol- 
lowers, to whom he explained, in his own way, the 
lectures of the day. 



MEMOIR OF THE AUTHOR. 



About this period of his life, Carroll was cured of 
a dangerous illness by a homoeopathic physician, after 
eminent practitioners of the " regular " school had failed. 
This circumstance made a deep impression upon both 
father and son, and led the latter to investigate the 
principles of homoeopathy, and to institute comparisons 
between the old and new methods of treatment. In fur- 
therance of this inquiry, after completing his college 
studies, he went to Philadelphia to seek the acquaintance 
of Dr. Constantine Hering, as one of the most learned 
physicians of the new school ; and not only profited 
largely by his teachings and advice, but (to use his own 
words) " I gained the most helpful, generous and genial 
friend I have ever made." 

It was the wise desire of both his father and 
himself that his preparation for the arduous duties of his 
profession should be as complete as possible. After 
graduating, therefore, instead of beginning to practice, he 
sailed for Europe, to glean a further harvest of observa- 
tion and study in foreign hospitals, and from the leaders 
of medical and surgical science abroad. In Dublin, he 
served as an " interne " in the Lying-in- Hospital ; he 
also investigated the Stokes treatment of fevers in Meath 
Hospital. While in Dublin he received a dissecting- 
wound, which nearly ended his career ; but, after the 
resident physicians had given him up to die, he called 
homoeopathy to his aid, and cured himself with Lachesis. 

From Dublin, Dr. Dunham went to Paris, where he 
studied specialties under such instructors as Bouillard, 
Velpeau, Trousseau, Ricord, Simon, Heurteloup, and 
others, while he also regularly visited the Homoeopathic 
Hospital under the charge of Tessier. From Paris he 
went to Berlin, and thence, after a brief stay, to Vienna, 
where he remained several months, attending the hospital 



X 



MEMOIR OF THE AUTHOR. 



cliniques of Wurmb, and the lectures of Kaspar on 
Materia Medica. From Vienna he directed his course to 
Miinster, to visit Bcenninghausen, who received the young 
physician with cordiality, and very soon learned to 
appreciate his tireless industry and active intelligence, and 
prophesied for him a brilliant future. Here the eager 
student remained long enough to watch numerous cases 
treated by Bcenninghausen, and to become thoroughly 
familiar with the methods of examining and prescribing 
for patients practised by that distinguished German. 

Having thus liberally availed himself of the advan- 
tages of foreign culture, Dr. Dunham turned his steps 
homeward. During the whole period of his absence he 
was in close correspondence with his father, between 
whom and himself there existed a rare degree of affec- 
tion and confidence. It had been his practice from his 
boyhood, when absent from home, to correspond almost 
daily with his father, and thus he acquired the habit of 
clear and terse expression, which is characteristic of all 
his writings. At a later period, his most elaborate arti- 
cles were rarely re-written, so effectual was his early 
training in intellectual work. It is worthy of remark, 
that wherever the young physician tarried for a season 
in his travels, he was sure to make warm and constant 
friends, with many of whom, eminent in the homoeo- 
pathic world, he kept up a life-long correspondence. 

On his return to America, he began practice in 
Brooklyn ; and at the very outset, so marked were his 
ability and success, that Dr. P. P. Wells, who had been an 
esteemed friend, as well as the physician, of the Dunham 
family for many years, says of Carroll : " He was always 
my friend, never my pupil." In February, 1854, Dr. Dun- 
ham married Miss Harriet E. Kellogg, daughter of Edward 
and Esther F. Kellogg, — a woman of rare personal 



MEMOIR OF THE AUTHOR. 



xi 



beauty and highly endowed mind. From this union 
resulted many years of domestic happiness, a helpful 
companionship and co-operation in his arduous labors, 
and the prolongation of his useful life through her tender 
watchfulness and devotion. So thoroughly were their two 
lives intertwined and identified, that they repeatedly told 
their children — as if to prepare them for the future — 
that should one parent die, they must expect the other 
soon to follow, — a prediction which was literally fulfilled, 
as in less than a year after Dr. Dunham's death, his 
wife was laid by his side in Greenwood. Her sad, brief 
widowhood was spent in an attempt to continue his life- 
labors by collecting and publishing in book-form his 
numerous, but scattered, contributions to medical science. 

In the year 1858, a severe attack of illness necessi- 
tated a removal from Brooklyn, and he took up his 
iesidence at Newburgh, N. Y. In this removal he sought 
rest of mind as well as of body, and it was not his 
intention to resume practice until fully restored ; but the 
remarkable success which attended his prescriptions in 
one or two cases which were pressed upon him with an 
urgency not to be denied, brought other claimants to his 
door ; and thus, in spite of the delicate state of his 
health, he soon became professionally busy. After resid- 
ing in Newburgh about six years, his health again gave 
way under an attack of cardiac rheumatism, and he 
removed for a short time to New-York. While there he 
had the assurance of leading specialists of the old school, 
whose prognosis was invited, that he could not long sur- 
vive. Upon this he sought the advice of Dr. Hering, 
who, after a careful and exhaustive examination of the 
symptoms, prescribed a single remedy (Lithium carboni- 
cum), which promptly conquered the disease. His own 
case thus, more than once, forcibly illustrated the sound- 



xii MEMOIR OF THE AUTHOR. 

ness of the medical rule -which he so often advocated, 
" a single remedy, and if possible, a single dose." Soon 
after, he moved his residence to Irvington-on-Hudspn, 
which he made his home, for the most part, until his 
death, having, however, an office and consulting practice 
in New-York to which he attended upon certain days in 
the week. 

During the whole of his active professional career, 
his health often gave way under the strain he put upon 
it, and he was several times compelled to seek a change 
of scene and climate. He visited Europe thrice in the 
pursuit of health; also, Nassau and other foreign resorts; 
but no suffering or sickness could prevent his active 
mind from utilizing his travels in the acquisition of 
knowledge, or blunt his zeal in the promotion of medical 
interests. During his last visit to Europe, though so 
weak and worn as to contemplate an unusually long 
absence, he exerted himself successfully to secure the 
good-will and co-operation of foreign physicians in his 
project of a "World's Homoeopathic Convention." 

The confidence in his ability to manage this scheme 
and carry it to a successful issue was so general among 
his colleagues, that our National Society conferred on him 
plenary power to arrange its details and to choose his 
associate workers. And in 1875, as has been truthfully 
said, " Our National Institute honored itself by electing 
him President for 1876, when the fruit of his special labor 
should be fully ripe." How efficiently he performed the 
duties of that office, and with what dignity, courtesy and 
fine tact he presided over that convention, few who were 
present will ever forget. A detailed history of that con- 
vention would show that in planning, arranging and 
executing his plans, he performed an amount of labor 
which few men could have borne. On April 27, 1876, 



MEMOIR OF THE AUTHOR. 



xiii 



he thus wrote to a professional friend : " The responses 
of our friends from abroad are very gratifying. Two 
years ago I had not much confidence ; but when I found 
that the thing was to be, I determined that it should be 
a success." And this letter contained a list of foreign 
communications aggregating one thousand four hundred 
and fifty-six pages of large paper, and in half a dozen 
different languages. More came in May and the first 
week of June, from foreign and home contributors, pre- 
senting a mass of manuscript to be translated, abridged, 
corrected and put through the press, before which a 
literary Hercules might have stood appalled. This work 
was done by him or under his personal supervision ; 
every article was carefully re-read by him, and the 
proofs were finally corrected by his pen ; and all this 
material was collected by him through a voluminous cor- 
respondence. In addition, he assumed the care of the 
general arrangements for the sessions of the convention 
in Philadelphia. "Of course," he wrote at this time to 
a friend, " I have convention on the brain. I cat, sleep 
and live it ; and have put some of my best blood into 
it ; '• adding words which now have a peculiar pathos, 
"but hope to have some left, when all is over." 

During the sessions of the convention in the -latter 
part of June, 1876, the heat was extreme, being often 
not less than ioo° Fahr. in the shade; but he clung to 
his post, though in daily danger of utter prostration, 
performing all his duties to the end. He left Philadel- 
phia, exhausted by his labors, and took a trip to the 
Upper Lakes, from which he returned so much improved 
that he thought himself strong enough for the remaining 
work of the convention. But he was immediately stricken 
down by a severe attack of diphtheria, from which, in his 
enfeebled condition, he convalesced slowly. He resumed 



xiv 



MEMOIR OF THE AUTHOR. 



his labors too soon ; but in the presence of duties unful- 
filled, it was simply impossible for him to be idle. On 
June 19th he had written to a friend: "I am better, but 
not yet in working order. I hope to be in New- York 
on Wednesday, however, and to be fit for work next 
week." The central desire in his mind, the one thing to 
strive for, was "to be fit for work." On September II, 
while confined to his bed at Irvington, he dictated to a 
friend at his bedside clear and definite instructions con- 
cerning the revisal of some manuscripts for the Centen- 
nial volume, and, nine days after, writes : " I am conva- 
lescent, but miserably feeble. It seems as if I never 
should feel strong again. I sit* up part of the day." 
Again, on October 6th: "Strength comes slowly, but 
it comes." 

He took to his bed, for the last time, on December 
2d, 1876, where he lingered, under the devoted care of 
his family, and his physicians Drs. Wells and Joslin, 
until February 18th following, when he passed peacefully 
to his rest, in his 49th year. "Though his death," says 
Dr. Joslin, " was obviously caused by exhausted vitality, 
consequent on his labors in connection with the World's 
Homoeopathic Convention, and though the nervous sys- 
tem must be looked upon as the main seat of trouble, 
still the mind remained clear to the last, and was never 
clouded during any period of his illness. His old friend 
and physician, Dr. Wells, who attended Dr. Dunham 
with me, remarked to me that he died of no disease, 
but from exhaustion produced by excessive and protracted 
labor. He had a certain irritating cough, originating 
apparently in a small spot in the larger bronchi, and 
relieved after a time by the expectoration of a small 
quantity of tough mucus. This was an annoyance, but 
could not be said to have had much influence on his 



MEMOIR OF THE AUTHOR. 



XV 



decline. An irregular fever was present, evidently vary- 
ing with every slight strain on his nervous system. His 
kidneys showed evidence of acute disease for several 
weeks, but this difficulty seemed to be passing off before 
his death. His old enemy, rheumatism, appeared in slight 
degree several times during his last illness. He had for 
many years been a sufferer from valvular disease of the 
heart ; but this was apparently rather improved than 
otherwise. He said he had kept watch over his heart 
with a flexible stethoscope, and was confident that no 
hypertrophy had taken place, which he attributed to the 
fact of his always being careful to keep well nourished, 
contrary, as he remarked, to some advice he had received." 

In a private letter, written to correct some misap- 
prehensions about his last illness, his wife writes thus : 
" A mind so acute as Dr. Dunham's could not have death 
approach his body and be unaware of it. Neither could 
a mind so exalted fail to submit tranquilly to an inev- 
itable fate, from which the spirituality of his life took 
away all fear. He passed as from one phase of life to 
another of equal or greater activity ; from one room in 
his Father's house to another. He said : ' I do not see 
my way through this illness ; ' and at the end of the 
seventh week, a month before he died, he said, with per- 
fect tranquillity : ' I shall go on in this way two weeks 
longer, and then I shall slip into my grave.' And again: 
' I shall go on in this way through the ninth week, and 
then I shall go to Greenwood.' Any one who knew the 
correctness of his professional prophecy, must, after these 
remarks, have struggled against conviction, to have any 
hope of his recovery. * * * He complained of no 
pain ; but from the beginning of his confinement, he 
constantly spoke of being ' perfectly wretched,' he could 
not tell how; but he never showed, as in former illnesses, 



xvi 



MEMOIR OF THE AUTHOR. 



any vigor underneath. * * * About five days before 
the last morning, I noticed a change in his complexion, 
and this deepened and became more permanent every 
day until the last moment. Up to that time he had 
wished the room cool ; from that time he frequently 
asked if it was warm enough. Sunday morning, about 
eight o'clock, he asked the temperature. When told that 
it was between 69 ° and 70 0 , he said : ' There is an 
unfriendly feeling in the air; you had better light the 
fire.' He lay and looked into the flame, saying : ' That 
is very pleasant ; ' and he watched us feed the flame, and 
seemed to enjoy the cheery influence, speaking now and 
then. And so he passed away a little before nine o'clock, 
without any struggle. He peacefully ceased to breathe." 

In some characters, opposing principles contend with 
varying fortune for mastery, and thus produce a com- 
plexity of contradictory phenomena, very difficult of anal- 
ysis. It is not easy, out of such conflicting elements, to 
form a just judgment of the man they constitute. But 
the character of Carroll Dunham was like a clear crystal, 
many-sided, indeed, but transparent throughout ; and his 
whole life was so harmonious, his consecration of himself 
to a noble ideal of duty so evident, that the friend of a 
few weeks and the friend of a life-time would form, essen- 
tially, the same judgment of him ; differing only in the 
degree in which they would comprehend and revere the 
rare nobility of his nature. 

Dr. Dunham was a voluminous writer, though he 
never concentrated his energies on the production of a 
single large work. He began to contribute articles to the 
medical journals when in Europe in 1852, and continued 
to do so steadily for twenty-five years, until death ended 
his labors. He devoted his efforts principally to the 
elaboration and perfection of the materia medica ; though 



MEMOIR OF THE AUTHOR. 



xvii 



many of his writings are of a miscellaneous character, 
being reports, reviews, clinical cases, public addresses, 
lectures, monographs and translations ; the most notable 
cf the last being Boenninghausen's work on whooping- 
cough. But these productions of his pen are not to be 
classed among the lighter or more ephemeral growths of 
medical literature. His faculty of giving his best powers 
to whatever he found to do, great or small, confers a 
permanent value on all that he wrote. He touched no 
subject without revealing something new and instructive, 
while the confidence he inspires in his statements, the 
judicial impartiality with which he treats matters in debate, 
and the lucid and manly language which he employs, 
give a rare zest to his compositions. There was no flaw 
in the fabric of his thought. He never said an unkind 
word or a silly one ; and his opponents (he had no ene- 
mies) always admitted that his criticisms were just and 
manly. Every utterance of his was as perfect as the 
workings of that noble mind could make it. All his 
speeches, all his writings, all his labors were, in every 
part, symmetrical ; for all were born of his earnest desire 
to "do good and communicate." Many of these con- 
tributions to our literature appeared in the " American 
Homoeopathic Review," of which he was editor for some 
years ; but all the prominent journals of our school, with 
scarcely an exception, were frequently enriched by articles 
from his pen. Besides his published writings, he main- 
tained a more or less active correspondence with profes- 
sional friends at home and abroad ; in which way his 
great influence was the more widely and thoroughly felt, 
in the advancement of medical science and especially of 
homoeopathic therapeutics. 

Always subordinating his private interests to his 
elevated sense of duty, Dr. Dunham never sought titular 



xviii 



MEMOIR OF THE AUTHOR. 



honors or any public recognition of what he was or what 
he had done. But honors found him out ; and he was, 
at various times, elected to high positions in many 
learned and scientific societies, both foreign and domestic; 
testimonials to his reputation as a physician and a scholar 
which were fully deserved. 

When the death of Dr. Dunham was announced, so 
general and profound was the sense of an irreparable 
loss, that the whole homoeopathic profession rose up as 
one man, both in this country and in Europe, to give 
utterance to their sorrow, to do honor to his memory, 
and to commemorate his character and services. Every 
one felt that we had "lost our best man." Special 
memorial meetings were called in many of our cities ; all 
our societies paid their mournful tribute to his worth ; 
obituary notices from the pens of our most distinguished 
men appeared in all our journals. Not even the death 
of Hahnemann stirred up such depths of grief; for Dun- 
ham, stricken down in the prime of his manhood, was 
nearly as widely known and admired, and was vastly 
more beloved. Perhaps we cannot give a better idea of 
the man, and of the impression which he made, than by 
quoting from some of the remarks and addresses which 
were then made as an offering to his memory. 

A life-long friend remarked : " He was many-sided to 
such an extent as I have never seen in any other man. 
His learning was surprising, his literary culture great, 
and his modesty great as either. He spoke the lan- 
guages of modern Europe as his own. His insight into 
the elements of disease, and into the nature of the agents 
by which they are cured, was wonderful. He has left 
an example which may God help us to follow ! " 

Another friend said of him : " Not long after the 
beginning of our acquaintance, we were associated in the 



MEMOIR OF THE AUTHOR. 



xix 



investigation of some professional controversies. I confess 
I was hardly prepared for the display of clear, discrimi- 
nating sagacity with which he took up the subject in 
dispute ; and the earnestness with which he pursued the 
delicate and unpleasant task to a logical conclusion. * * * 
Most of the members of this society know something of 
the important part he took in the reorganization of our 
medical college. But few are aware of the amount of 
arduous labor which he gave to that business, or of the 
peculiar difficulties he surmounted in its accomplishment. 
* * * His opinions always commanded respect, and 
usually controlled the course of action. And it may be 
said, without hesitation, that the existing laws of the 
State for regulating medical practice and for suppressing 
quackery owe much of their fair and liberal character to 
the influence he exerted. * * * Though the functions 
of arbitrator or inquisitor were not congenial to his 
modest and retiring disposition, yet he never hesitated to 
occupy any position or perform any duty legitimately 
imposed upon him. * * * In the social circle, amongst 
neighbors and friends, his genial nature shone conspicuous. 
With a vast fund of curious and interesting information, 
gathered from books and travel, he possessed a rare wit, 
and a fine appreciation of humor, which gave to his 
conversation a delightful charm and freshness." 

The committee of the New- York County Homoeo- 
pathic Medical Society, after bearing grateful testimony 
to his invaluable contributions to the materia medica, in 
the knowledge and practical application of which he was 
almost without a peer, speak thus of his qualities : 
" Possessing intellectual capacities of the highest order, 
he never exerted them for selfish ends, but always for 
the public good. Pure in his private life, exceptionally 
modest and retiring in his demeanor, ever gentle and 



XX 



MEMOIR OF THE AUTHOR. 



kind, he knew not how to stoop to meanness and detrac- 
tion ; generous and large-hearted, he was always ready 
to aid others, and all who were brought in contact with 
his noble and tender nature were compelled not only to 
admire and venerate the accomplished physician, but to 
trust and love the true-hearted Christian man." 

From a Western physician we have this testimony : 
" At the meetings of our institute, he was the one who 
moved about the most quietly, who came and went with 
the least parade, and who, while he spoke very seldom 
in debate, always spoke to the purpose. He was the 
member whose committee never failed to report, and 
whose papers were always well digested, clear, concise, 
practical, and ready for the printer. He was the source 
of appeal for men on both sides of mooted questions. 
His influence was almost unbounded. He had the skill 
and tact of a great diplomatist, but these were never 
used for his own personal purposes. His pen was 
his sword, — the sword of Melancthon and not of 
Luther, bright, keen, trenchant, — but it can truly be 
said that it ' never carried a heart-stain away on its 
blade.' " 

Another friend said : " His life was one of truth and 
goodness. His name can never be mentioned without 
awakening feelings of love and reverence. His action in 
all matters, great or small, was prompted by purity of 
heart and love of right. By years of devotion to his 
profession, by his searching investigations, by his lucid 
writings, by his spotless integrity, and by his sincerity of 
purpose, he acquired unequaled influence among his col- 
leagues; and I truly believe that Carroll Dunham has done 
more for the interests of homoeopathy, not only in this 
city or country, but in the world at large, than any other 
man since the time of Hahnemann." 



MEMOIR OF THE AUTHOR. 



xxi 



His life-long friend, Dr. P. P. Wells, said, after his 
death: "I would willingly have died for him." 

One who had known him from his boyhood thus 
spoke of him : " When I pass in review the thirty-five 
years of our friendship, I can honestly and heartily say, 
that I do not remember a single word or act of his for 
which any of his friends need blush, or which he, now 
gone to his last account, would wish to be unsaid or 
undone. The only impatience I ever felt toward him 
during this long period, arose a few times because his 
calm, deliberative nature refused to plunge into the arena 
of medical polemics. But he was so magnanimous, or to 
use the more expressive Saxon word, so large-minded, 
that he could not be partisan ; he could not but view 
both sides of every question at issue, and, as a conse- 
quence, he was liberal and generous even to his opponents, 
always ready to make allowance for the opinions and 
acts of those who differed with him. He was truly one 
of the 'blessed peace-makers.' The character of his 
mind was essentially judicial ; approaching a subject 
impartially, he calmly weighed it in all its bearings ; and 
had he been educated for the bar, his keen intellect and 
sound judgment would have graced the highest bench in 
the land. Actuated by an earnest love of truth and 
justice, he was thoroughly unselfish and always subordi- 
nated his private interests to the good of the cause with 
which he was identified. More than this : his whole life 
was devoted, in a most self-sacrificing spirit, to the duties 
which the profession laid upon his willing shoulders ; 
duties and responsibilities which he never refused and 
which came to him unsought, simply because all recog- 
nized his eminent fitness for their discharge. Thus he 
was often overburdened, and on several occasions his fail- 
ing health compelled him to break off from all labor, and 



XXII 



MEMOIR OF THE AUTHOR. 



go abroad to rest and recuperate. But the moment he 
returned, those labors were resumed ; and when, at last, 
exhausted nature succumbed, his death was merely the 
crowning act of a whole life of self-sacrifice. Though 
not physically strong, he was a steady worker and close 
student ; and though independent of his income as a 
practitioner, and possessed of a competence by inherit- 
ance, which would, especially in view of his impaired 
health, have justified him in leading a life of elegant 
leisure, he accomplished an immense amount of literary 
labor ; more, in fact, than most men, in full health and 
impelled by necessity, could have performed. 

" His judgment was so sound, his convictions so 
sincere, his aims so unselfish, his life so pure, his sym- 
pathies so tender ; he was so free from conceit or arro- 
gance, so modest and unobtrusive, so devoid of petty 
ambitions, so intent on doing his whole duty, so liberal 
and tolerant toward those who differed with him, that he 
commanded the respect and won the affection of all who 
knew him. He wielded an immense power for good, not 
only by what he actually did, but by the mere force of 
his example, cf a quiet, honest, thoughtful life. 

" I have spoken of him as unselfish ; I may add, 
from my private knowledge, that he was very generous 
and open-handed to all in need, imparting freely not 
only of his stores of knowledge, but of his purse. I 
could recount many acts of kindly charity and timely 
aid to poor struggling brethren ; but I refrain, for he was 
one of those who never let their right hand know what 
their left hand gives. 

" His unvarying cheerfulness was another marked 
characteristic. Notwithstanding his physical infirmities and 
his engrossing labors, he always seemed to dwell in a 
bright and serene atmosphere, full of hope and peace. 



MEMOIR OF THE AUTHOR. 



xxiii 



His very presence was refreshing and inspiriting ; he went 
in and out among us, impressing all with the conviction 
that he was a true man, who had consecrated his life to 
a noble ideal of duty. 

" Yes, friends and colleagues, we have lost our noblest 
and best man, one who was the heart and soul of the 
highest work done in our profession. In him we lose 
more than we now know ; for, ' take him all in all, we 
ne'er shall look upon his like again.' But those who were 
so blessed as to call him friend, will always be thankful 
for his life and example ; for such a man as he ennobles 
not only the age in which he lived, but humanity 
itself." 

Much more might be quoted of the same purport; 
but these extracts will suffice to show how great and 
good a man was Carroll Dunham ; as true a hero as 
ever fell in the front of battle, fighting for the right. 

We cannot close this brief memorial more fitly than 
by quoting his parting words to his class, for they strike 
the key-note of his own life : 

" May you have the pleasant consciousness, not only 
that you have made some permanent additions to the 
common stock of knowledge for the common good, but 
also that many men and women have been the happier 
for your lives." 

E. M. Kellogg, M. D. 



MATERIA MEDICA AND 
THERAPEUTICS. 



IN the exercise of any art which involves the use 
of tools or implements of any kind, the first 
condition essential to success is this : 

That the scope and limits of the art be clearly 
defined and well understood, in order that no attempt 
may be made to exercise the art under circumstances 
which do not call for it, and which would necessarily 
preclude success. 

A second condition no less essential is a thorough 
familiarity with the tools or implements of the art; 
the origin, nature, powers and capabilities of each, 
and their relations to each other. This knowledge 
will teach us properly to select our tools according 
to the work we have to perform. 

The problems before the artisan, then, are these : 

1. When to use his tools. 

2. What tools to select for each piece of work. 

3. When selected, how to use them. 

The practitioner of medicine, in the exercise of 
his profession, performs many functions. He may 
act simply as a diagnosticator of disease, detecting 
2 



2 MATERIA MEDICA AND THERAPEUTICS. 



and explaining the seat and effects of disease, but 
without undertaking to treat it. Or, if he undertake 
to restore the sick to health, he may act simply as 
a surgeon, employing mechanical means alone, doing, 
as the etymology of the word surgeon or chirurgeon 
implies, handiwork. Or, he may act as the chemist, 
antidoting by chemical re-agents, noxious substances 
that are acting injuriously upon the body. Or, he 
may act as hygienist, bringing the laws of physi- 
ology to bear upon the regimen of his patient, and 
so ordering his mode of life as to eliminate the dis- 
coverable cause of disease. Or, finally, he may act 
as a therapeutist, by introducing into the organism 
of the patient certain substances from the external 
world which have the pow r er of producing special 
modifications in the condition of the organism ; and 
by means of these modifications he aims to cause 
the diseased action of the organism to cease and to 
be supplanted by the normal healthy action. 

It is only with the practitioner of medicine in his 
last-named capacity, viz., as therapeutist, or curer of 
disease by means of drugs, that we have to do in 
the study of the sciences of materia medica and ther- 
apeutics. 

The practitioner of medicine, in this capacity, 
employs certain tools or implements called drugs. 
These are the tools of his art. The problems before 
him are to determine : 

1. When these tools are to be employed. 

2. Their nature, history, and properties, collect- 
ively and individually. 



MATERIA MEDICA AND THERAPEUTICS. 



3 



3. How they are to be used. 

The first of these problems, viz. : When and under 
what circumstances are drugs to be employed in 
taking care of the sick ? has met with a variety of 
practical answers at different periods in medical his- 
tory. At one time by a certain class of physicians, 
as is well known, drugs were universally and most 
lavishly employed in all cases of sickness. Another 
school in our own day goes to the opposite extreme 
of denying the power of drugs to control the course 
or result of disease, and altogether abstains from 
using them. Between these extremes there are all 
degrees of opinion and practice. 

One might think that as this is a practical ques- 
tion, it might be settled by an appeal to experiment. 
But it is obvious that no experiments can be 
decisive, unless the experimenters agree upon the 
mode of making them. Two series of experiments 
cannot be compared unless their conditions are 
identical. 

If one carpenter should use a plane to make 
smooth the surface of a plank, and another should 
use a gouge for the same purpose, these two artisans, 
on comparing results, would be found to have formed 
very different opinions respecting the efficiency of 
tools. Now, it is notorious that physicians have been 
altogether at variance in respect of the principles 
upon which drugs should be selected and the mode 
in which they should be used in treating disease. 
This will account for the unsettled state of the prob- 
lem we are considering. 



4 MATERIA MEDICA AND THERAPEUTICS. 



As has been said, there is an influential school 
of medicine — the expectant or physiological — which 
professes to abstain altogether from the use of drugs. 
Some advocates of this school argue, upon theoretical 
physiological grounds, that it is impossible for drugs 
to alter the course of action upon which the organ- 
ism has entered in disease; that the organism must 
be allowed to carry out this course of action to its 
physiological conclusions, — indeed cannot be pre- 
vented from so doing. The fallacy of these argu- 
ments will be shown hereafter. 

Others of this school point to the great successes 
of homoeopathic and hydropathic physicians as proofs 
that drugs are a mischief and a mischief only. But 
this argument rests on the erroneous assumption that 
homceopathists use no drugs. 

The legitimate conclusion from the successes of 
homceopathists and hydropathists is, that drugs 
unnecessarily and wrongly used are potent for evil ; 
and the practical lesson to be drawn from this con- 
clusion is, that it is a matter of the first importance 
to learn when it is necessary to use drugs and how 
to select and use the right drug for each case. 

When called upon to take charge of a sick per- 
son, the first business of the practitioner is to make a 
diagnosis, — in homely words, to find out what ails the 
sufferer. The prognosis follows upon the diagnosis, 
and may be called a part of it. In doing this the 
practitioner observes the objective condition and sur- 
roundings of the patient, hears his subjective symp- 
toms from the patient himself if he is able to state 



MATERIA MEDICA AND THERAPEUTICS. 



them, or from his friends ; and listens to the previous 
history of the case He inquires into the previous 
habits and occupations of the patient, ascertains 
whether he has been subjected to exposure or fatigue 
of mind or body, has been in the way of contagions 
or miasms of any kind, has been guilty of excesses 
or subjected to privations. Again, he looks for indi- 
cations of any taint of constitution, any morbid 
diathesis inherited or acquired. In this way he 
endeavors to add to direct observations of the 
patient's present condition a knowledge of the pre- 
disposing and exciting causes of the disease under 
which he is laboring. Upon these data he forms 
his diagnosis. And up to a certain point his treat- 
ment is governed by his diagnosis. If, for instance, 
he finds the patient lying at the point of death from 
a mortal wound, or from cerebral apoplexy, or from 
whatever cause, he can do no more than communicate 
to the friends his diagnosis and prognosis, his view 
of the nature of the disease and his prediction of its 
course and termination, and leave the patient to their 
kind offices. Or if he find a wound, a fracture, a 
hernia, his diagnosis will be made accordingly ; and, 
whatever his prognosis, he will employ the appro- 
priate surgical means for closing the wound, adjusting 
the fractured parts, or reducing the hernia ; and here- 
with, if there be no complication, his business will 
come to an end. Or if, again, he find as the excit- 
ing cause of the disease, some violation of the laws 
of health, his first business will be to cause this viola- 
tion to cease. If it have been an error in diet, the 



6 MATERIA MEDICA AND THERAPEUTICS. 

diet must be regulated. If an unduly small or unduly 
great amount of exercise, this must be corrected ; if 
an improper exposure to heat or cold, light or dark- 
ness, this must be adjusted ; excesses must be curbed, 
deficiencies made up. In a great many cases, such 
an attention as this to the hygienic needs of the 
body will suffice to restore the patient's health. In 
every case it is to be the first concern of the phy- 
sician ; for, you may be well assured, without this 
care all administration of drugs will be in vain. 

How to do in detail all that has been briefly 
alluded to as the duty of the practitioner in certain 
specified and in all similar cases, will be taught from 
the chairs of surgery, physiology, chemistry, and 
theory and practice. But from each of these chairs 
save that of chemistry, and, above all, from the 
chair of pathology, it will every day be taught that 
in a large number, I might say in a large majority, 
of cases of sickness, no amount of attention to the 
hygienic needs of the patient will be sufficient to 
put an end to his illness and restore him to health. 
Should his habits be regulated with the strictest 
observance of physiological laws, there will still be 
observed in him a diseased action of the organism, 
which, unless arrested or changed into a healthy 
action, will result in some kind of injury or deformity 
of one or more organs of the body, or may result 
in death. 

Now, since in the case supposed the procedures of 
hygiene have failed to effect this necessary change of 
the morbid action into healthy action; since, although 



MATERIA MEDICA AND THERAPEUTICS. 



7 



the conditions and surroundings and diet and habits 
of the patient are just what they should be, neverthe- 
less the disease continues to progress and to injure 
or even destroy the organs of his body, we must 
either leave him to his fate, trust to nature to cure 
him, — a cruel step-mother, as I shall show, some- 
times called kind and benignant, but only so because 
less cruel than a false and monstrous system of 
therapeutics, now happily declining, — I say we must 
leave him to his fate, or else we must find some 
particular means of bringing to bear on the diseased 
organism an influence capable of converting its mor- 
bid action into healthy action. 

An influence of this kind is that which is exerted 
by drugs. Cases requiring the exercise of this in- 
fluence, — cases in which hygiene has failed, or in 
which experience has shown that hygiene will fail, to 
arrest the morbid action of the organism, — these are 
the province of therapeutics, these are the cases in 
which drugs should be employed. 

This may be made more clear by illustrations. 
Suppose a case of inflammation of the lungs. The 
patient is seen in the first stage, that of congestion. 
The physician ascertains the exciting cause, which 
has probably been undue exposure to cold winds or 
to a wet atmosphere, conjoined to a predisposing 
weakness of the lungs. All means are at once 
employed to adjust the temperature of the apart- 
ment, so as to supplement the deficiency of heat, 
by which in part the malady was induced. Expe- 
rience has abundantly demonstrated that this care 



8 MATERIA MEDICA AND THERAPEUTICS. 

will not be sufficient to restore the lung to its nor- 
mal state. Pathology teaches that in this stage the 
capillaries of the lungs are gorged to their utmost 
capacity ; that the blood has almost if not altogether 
ceased to course through these capillaries ; that the 
lining membrane of the air-cell in the part affected 
has ceased to perform its normal function ; and that 
if this state of things continue, the membrane of 
capillaries and air-cells will assume a new function 
and will pour out an exudation which will fill up 
and obliterate the air-cell. If, in this state of things, 
we could bring to bear upon the patient some 
influence capable of acting just exactly upon the 
part affected by the disease, and of so acting as to 
resolve this stasis and set the blood in motion again ; 
thus to relieve the gorged capillaries and to restore 
to the membrane of the air-cell the peculiar power 
which nature gave it, this influence would promptly 
effect a cure. It is an influence of this kind which 
we exert when we give a drug which is a specific for 
any diseased condition. And the object of the science 
of materia medica is to discover drugs which possess 
properties of this character, to ascertain the particular 
properties of each drug, and to learn how to give 
each drug in just those cases in which its peculiar 
properties will enable it to exercise such an influence 
as has been described. 

If, in the case of inflammation of the lungs which 
has been supposed, we know of no such drug, but 
leave the case to nature, as the saying is, why then, 
either the inflammation and the consequent exuda- 



MATERIA MEDICA AND THERAPEUTICS. 



9 



tion are so extensive as to consolidate a larger part 
of the lung than the patient can spare, and death 
follows ; or else after a long and tedious illness the 
exudation ceases to be poured out, and then becomes 
more or less completely absorbed again. This ab- 
sorption, however, is rarely complete. The lung. is 
left more or less consolidated and unfit for purposes 
of respiration, and more or less prone to the for- 
mation of secondary abscesses or of a nidus for the 
deposit of tubercle, while the patient goes forth again 
more or less a cripple in his respiratory organs. 

Such is the benignity of nature, to whose cura- 
tive power we are counseled to intrust our patients 
rather than endeavor to produce specific cures by 
means of drugs. 

Let us meet, at once and for all, this question 
of nature as the great curer, superseding all the 
appliances of art. 

How does nature amputate a limb ? First she 
rots the skin, then she rots the muscles, then she 
rots the fasciae and the vessels and the nerves, 
leaving them hanging out from the stump ; last of 
all, after a long period, the bone, becoming dead 
and brittle, by some happy chance gets broken off. 
There is left a conical stump that will not bear to 
be touched, that will not tolerate an artificial limb, 
that is a torment to the patient, if indeed the months 
of suffering which the operation involves, or the 
drain of the constant discharges have not before 
this time carried him off. Compare this process and 
result with the expeditious amputations, the conven- 



IO MATERIA MEDICA AND THERAPEUTICS. 



ient stumps and the shapely and helpful artificial 
limbs of modern , surgery ! Dr. John Ware says that 
" the business of the medical practitioner is to stand 
between the patient and his friends and prevent the 
latter from interfering with the processes of nature ! " 

. He would not think of applying this doctrine 
to the case of amputation ! But he can be justified 
in applying it to cases of internal disease only on 
the assumption that he has as yet no knowledge 
of any better method than nature's. If this be so, 
then it should be stated as a fact affecting present 
time only, not laid down as a principle to hold 
good forever ! 

H ow does nature relieve a non-inflammatory 
congestion of the lung ? By opening a blood-vessel 
into one of the air-tubes and causing an haemop- 
tysis. We very well know the ordinary sequelae of 
pulmonary haemorrhage, and how few are they who 
escape its termination in consumption ! Is nature 
to be imitated in this ? 

How does nature cure a surplus of acid in the 
blood? By deposits in the joints, inflaming their 
synovial membranes and destroying the function ol 
the joints, or by deposits in the kidneys or bladder 
causing nephritis or cystitis or calculi, or both. Shall 
we, from a superstitious devotion to nature, withhold 
ourselves from seeking out a better mode of cure? 

It may be objected that this is not a fair state- 
ment of the doctrine which is, that we are to imi- 
tate nature, not in her mode of eliminating the 
proximate cause of the disease, but in the fact of 



MATERIA MEDICA AND THERAPEUTICS. I I 

its elimination. This reduces nature's teaching to 
the simple lesson that we are to "get rid of what 
annoys us," leaving us to find out the ways and 
means. So axiomatic a piece of advice as this 
would hardly seem to call for the admiration which 
has been expended on "nature, the great healer of 
diseases ! " 

The manner in which it has been proposed 
to imitate nature in the cases alluded to is this: 
Whereas in case of pulmonary congestion, she 
abstracts blood from the lungs, the doctors take it 
from the arm ; whereas she gets rid of the excess 
of acid in the blood by pouring it into the joints 
and the kidneys, the doctors neutralize it by intro- 
ducing an alkali into the blood. 

But the result of this indirect imitation of nature 
does not differ much from that of a direct imitation. 
The cause of the pulmonary congestion being left 
unaffected, this congestion continues to be produced, 
notwithstanding that the doctor abstracts blood 
from the arm to relieve it. The continued conges- 
tion exhausts the patient by interfering with respira- 
tion. The doctor at the same time exhausts him, 
taking away his blood to cure the ever-reproduced 
congestion. Between disease and doctor the patient 
dies ! And in this termination, there is still an 
imitation of nature ! For does not nature put an 
end to the life of every living creature ? 

Let us take a higher view of these matters. Let 
us take a lesson from the Creator alike of ourselves 
and of that which we call nature ! 



MATERIA MEDICA AND THERAPEUTICS. 



Man comes into the world the most helpless of 
all living creatures, the feeblest, apparently the least 
provided for. If we look no higher than to the 
operations of external nature, we should say that his 
race must perish from off the earth, a victim of 
cold, of starvation, of maladies to which more than 
any other creature he is subject. The very opposite 
of all this happens. Every apparent law of nature 
is controverted. Man, the feeblest creature, domi- 
nates the earth. Every animal is subject to him. 
The three kingdoms of nature, throughout the globe, 
minister to his needs. How comes this contradic- 
tion ? By the exercise of the intellectual faculties 
with which man has been endowed, man the feeble 
becomes mighty. Naked, he clothes himself with 
the spoils of animal and vegetable creation. Sur- 
rounded by crude food, yet unable to digest it in 
its natural state, his inventive faculties contrive for 
him the means of converting raw flesh and crude 
vegetables into delicate and savory nutriment, for 
which he gathers condiments from the ends of the 
earth. An easy victim of a host of miasms, he is 
endowed with intelligence to discover and with 
energy to procure, from distant climes if need be, 
specific remedies for the cure of every malady and 
the alleviation of every physical suffering. That 
he has to some extent succeeded in applying this 
intelligence to this beneficent end, is a guarantee 
of a success that may increase until we shall have 
a remedy for every ailment. 

That We hitherto lack a great number of spe- 



MATERIA MEDICA AND THERAPEUTICS. 1 3 



cifics, this fact, instead of throwing us back into 
that stolid reliance upon nature, that stolid submis- 
sion to the ills of our original state which is char- 
acteristic of the unenlightened savage, may well 
incite us to renewed exertions in this path of inves- 
tigation and discovery so fruitful of blessings to our 
race ! 

To return now from this digression, we perceive 
that our first question may be answered as follows : 

Drugs are to be used in cases in which disease 
persists after the employment of such mechanical, 
chemical or hygienic means, or all of them, as the 
laws of physiology may indicate, shall have proved 
ineffectual or insufficient to change the morbid 
action of the organism into a healthy action. 

The employment of drugs must always be sec- 
ondary and subordinate to a resort to hygienic 
measures. 

HavinQf thus determined when dru^s are to be 
employed, viz. : when, after the exciting causes of 
disease have been removed, the disease still persists, 
and when some special influence from without the 
body is needed to bring it back into the way of 
healthy action, we come now to the second problem, 
viz. : 

What is the nature of drugs in general, and 
how to ascertain the nature and properties of each 
particular drug. 

The organism is made up of organs which per- 
form their functions by virtue of a susceptibility 
which the tissues of which they are composed pos- 



MATERIA MEDICA AND THERAPEUTICS. 



sess to certain stimuli which are necessary to life, 
and which are called general stimuli. These general 
stimuli are light, heat, electricity, air, moisture, ali- 
ment. The tissues of the lung are endowed with a 
susceptibility to the atmospheric air which acts as a 
stimulus to them, and under the influence of which 
they perform the function of respiration. If this 
stimulus be withdrawn, the lungs cease to perform 
this function, and the animal perishes. If the quan- 
tity or quality of this stimulus be much altered, the 
function is performed in an unnatural or diseased 
manner, and sickness results. Heat is also a stim- 
ulus to the lungs as well as to other organs. 
Aliment is a stimulus to the digestive apparatus. 
Instances of this kind might be multiplied. 

Now, it is well understood that when one of 
these stimuli has been in excess or in deficit, and 
consequently the function of the corresponding organ 
or apparatus comes to be abnormally performed, it 
will often be sufficient to re-adjust the proportion of 
the stimuli, for the organism to recur to its normal 
condition. To accomplish this re-adjustment is the 
task of the science of hygiene. 

But, furthermore, it is also well known, as has 
been already stated, that hygiene, though it may 
with perfect nicety re-adjust the proportions of the 
general stimuli by virtue of which life goes on, is 
not always able by this re-adjustment to restore the 
organism to its former healthy condition. The 
organ or apparatus, which, through some deficiency 
or excess or perversion of some stimulus or other, 



MATERIA MEDICA AND THERAPEUTICS. 1 5 

became diseased, will often remain diseased after 
hygiene has corrected the disproportioned stimulus. 
Permanent disease exists, and hygiene has done all 
it can do. 

In this state of things we are powerless unless 
we can bring to bear upon the diseased organ 
some influence which may have the power to di- 
rectly convert its diseased action into the pristine 
healthy action. This, it will be conceded, is the 
desideratum and this must, in some way or other, 
be accomplished. The substances in which such 
influences reside are what we call drugs. 

We now perceive the two requisite conditions 
for the successful employment of drugs in treating 
sickness. 

1. We must possess substances which are capa- 
ble of exerting such an influence upon the different 
organs of the body as to be able to produce defi- 
nite changes in the mode of action of these organs: 
and 

2. We must know how to apply this knowledge 
of the action of drugs to particular cases of sickness. 

As a consequence of what has been said, then, 
a drug may, in general, be defined as being any 
substance which is capable of changing or definitely 
modifying the mode in which any organ or system 
of the body performs its functions, or of changing 
or modifying the tissues of the body. 

The study of materia medica is the study of the 
nature and properties of drugs. How, then, are 
these to be ascertained? It may not be unprofitable 



1 6 MATERIA MEDICA AND THERAPEUTICS. 



to glance briefly at the history of the materia 
medica at this point. 

There was a time when it was supposed that the 
properties of drugs were indicated by their physical 
properties, their color, odor, shape or taste. Thus, 
aloes, from the yellow color of its solution and from 
its bitter taste, was conceived to act pre-eminently 
upon the liver. 

This was the famous doctrine of the Signature, 
most groundless and fanciful, and yet, like every 
other visionary notion, it was not without some sem- 
blance of support in analogy. 

The chemical properties of substances furnished 
another supposed means of ascertaining their sup- 
posed properties as drugs. If they were to be 
employed as chemical re-agents in the cure of dis- 
ease nothing- could be more rational. But it must 
be remembered that we know but little about the 
chemistry of disease; indeed, that chemistry deals 
only with the results of organic action, while we 
aim, by the action of drugs, to modify organic action 
itself. Furthermore, experience shows us that sub- 
stances possessing analogous chemical action pro- 
duce very different effects as drugs. And, finally, 
when we come to the vegetable kingdom, we find 
the chemical composition and reactions of the dif- 
ferent varieties to be nearly identical, while their 
action upon the vital organism is as various as 
could be imagined. 

But leaving the history of materia medica, let us 
ask ourselves again what it is that we seek? To find 



MATEHIA MEDICA AND THERAPEUTICS. I 7 

out the properties of substances that we suppose to 
be drugs, to ascertain whether substances which we 
are investigating be really drugs or not, i. e., whether 
they be capable of modifying the action of the 
organs of the body. What method so direct, so 
simple, so certain, as to test them on the living body; 
not on the lower animals, for these are often variously 
affected by drugs; but on the human beings for whose 
benefit they are to be employed as medicines. 

But shall they be tested on the sick? This 
might be regarded as hardly justifiable, or if it were 
justifiable, it would be difficult to draw an inference 
from the action upon one case of sickness respect- 
ing its action upon another case of sickness; since 
each case of sickness is different from every other 
case. And then again, if we were to gain knowl- 
edge of drugs only by experimenting on the sick, 
and this knowledge were to serve us only in case 
we should meet a similar case of sickness again, 
our knowledge would be always too late to be of 
service. We should know well what had happened, 
but should have no store of general knowledge 
ready for any case that might occur. 

It is a general rule in physics, that when we try 
an experiment we should have every element that 
enters into the experiment in as normal a condition 
as possible. This can only be done if we experi- 
ment on the body in health. 

Accordingly, all trustworthy and useful knowl- 
edge of drugs has been obtained by experiments 
upon the healthy subject. 
3 



l8 MATERIA MEDICA AND THERAPEUTICS. 

Such experiments are what we call provings of 
drugs. They are made by greater or less numbers 
of independent observers. The coincidences of 
effects observed by independent provers are cheering 
evidences of the correctness of this method. By 
the application of physiological knowledge to the 
results of these provings, a more or less complete 
appreciation of the action of a drug may be gathered. 

It is in this way that we ascertain the nature and 
properties of drugs. 

The special method and importance of drug- 
proving will form the subject of a future lecture. 



STUDY OF MATERIA MEDICA. 



IN our last lecture we discussed the nature of the 
sciences of materia medica and therapeutics, 
defining the one to comprise a knowledge of the 
properties of drugs, and the other a knowledge of 
the method of using drugs to cure sick people. 

We then discussed two of the three general 
problems which present themselves to the medical 
practitioner in his 'capacity as a curer of disease by 
means of drugs. These were : 

1. Under what circumstances of sickness he is 
called upon and required to resort to the use of 
drugs in treating disease. 

2. The means of ascertaining the properties of 
drugs. To this second problem I wish to devote 
a few more words, for I greatly desire that you 
should very clearly understand the impossibility of 
acquiring a definite and complete knowledge of the 
absolute and positive properties of drugs in any 
other way than by provings upon the healthy 
subject. 

Observations of the action of drugs upon the 
sick teach the properties of the drug in relation to 



20 



STUDY OF MATERIA MEDICA. 



the organism when in that particular abnormal con- 
dition, but give us no absolute knowledge of its 
constant action upon the organism. Yet we can 
have no science of therapeutics without some such 
knowledge of the constant and uniform properties 
of drugs. 

If we give mercury to a patient laboring under 
B right's disease, we find that an exceedingly small 
.quantity produces a very powerful and remarkable 
effect, and such an effect as we see from mercury 
under no other circumstances. 

Now, this knowledge would be of service to us 
if we should contemplate giving mercury in another 
case of Bright's disease ; but it would not help us 
at all if the question were whether or not we should 
give mercury in some other disease, as for example, 
pericarditis. And yet you will perceive that one 
great essential of a science of therapeutics is, that 
it shall enable us to predict the effect of the appli- 
cation of a drug in a new case; to know before- 
hand what effect we shall be able to produce; and 
by this knowledge to select a drug capable of pro- 
ducing the effect we desire. 

Now, on the other hand, if a dozen or a 
hundred healthy persons take mercur)^ the effects 
produced on them are, with the exception of slight 
differences depending on the idiosyncrasies of the 
provers, identical. This method then enables us to 
gain an absolute knowledge of the constant and 
uniform properties of drugs in their relation to the 
living organism. 



STUDY OF .MATERIA MEDICA. 



2 I 



If now, having gained this knowledge, we could 
advance a step farther, and find out what relation 
the effects which a drug produces on the healthy 
subject bear to those symptoms of disease which 
the drug is capable of removing, we should possess 
the elements of the much desired science. For, 
then, having the symptoms of the disease before 
us, and knowing the relationship which these symp- 
toms bear to the effects of a drug capable of remov- 
ing them, we could select our drug with a priori 
certainty of curing our patient. 

Having thus considered the problem of the 
general nature and properties of drugs, and the 
method of ascertaining these properties, we come 
now to the third problem : How to use drugs. 

Let us suppose that by the method already 
pointed out, viz. : experiment on the healthy human 
subject, we have gained a tolerably accurate knowl- 
edge of the properties and powers of certain drugs 
to modify the action of the organism. 

Let us further suppose that a sick person is 
under our charge, in whose case the resources of 
hygiene have already been exhausted and to no 
purpose. His regimen and food have been regu- 
lated as well as could be desired. Still he does 
not recover. The interposition of some influence 
from without is needed to restore him to health. In 
short, drugs are required. We know the properties 
of a variety of drugs, their action on the healthy 
subject. The question now is how, on the basis of 
this knowledge, shall we select a suitable remedy 



22 



STUDY OF MATERiA MEDICA. 



for the sick man? How shall we apply our knowl- 
edge of the action of the drug on the healthy sub- 
ject, so as to know what drug to select for this, 
particular case of sickness? We demand, in other 
words, a principle or law for the selection of reme- 
dies. The selection and administration of remedies 
constitute the science of therapeutics, as the inves- 
tigation of the properties of drugs constitutes the 
science of materia medica; and the principle or law 
of which we are in quest would be the great central 
principle of the science of therapeutics, just as the 
law of attraction is the central principle of the sci- 
ence of mechanics, and the law of the diffusion of 
light is the central principle of optics. It is impos- 
sible to conceive of a science (properly so called) 
without some such fundamental principle. A collec- 
tion of facts bearing on therapeutics might be made 
which would be an interesting historical resume 
of what had been done in the past, but which 
would be of but little or no service to the physician 
in the treatment of any new case, — which would 
not enable him to predict the result of treatment in 
a new case. And yet there are some medical men 
who deny the necessity for any therapeutic law and 
rely only on unmethodized experience. Of these 
we shall presently speak at greater length. 

I wish now to speak of the physiological school, 
so called, as that which makes, just now, the loudest 
claims to exclusive possession of the truly scientific 
method of treating diseases. I shall speak of it at 
some length, because it is of the greatest impor- 



STUDY OF MATERIA MEDICA. 



23 



tance that you learn as early in your studies 
as possible to analyze closely and fearlessly all 
claims and pretensions of this kind, and that you 
learn to distinguish clearly between assumptions 
and facts. 

The physiological school scoffs at a therapeutic 
law, because a law of this kind is empirical, and 
does not rest on a rational understanding of the 
causes of disease. And this is true. It is likewise 
true of physics. The laws of the attraction of grav- 
itation, and of the diffusion of light and of chemical 
affinity, in definite proportions, are empirical laws. 
They do not rest on a rational understanding of 
the causes of the phenomena with which they deal 
respectively, for, in truth, we know nothing about the 
causes of these phenomena, and have never been 
able to find out anything about them. These laws 
are simply inductions from a multitude of observed 
facts. But the physiological school undertakes to 
find out the causes of the phenomena of disease; 
to trace the symptoms of disease back to their ulti- 
mate origin, and then acting on the general princi- 
ple, "remove the cause and the effect will cease," 
to remove the cause thus discovered and so cure 
the disease. 

We have shown that in matters of hygiene this 
is possible and is the true method. It would be 
the true method in therapeutics if it were possible. 
But it is not possible, as we shall best show by an 
example. 

Suppose a fully developed inflammation of the 



2 4 



STUDY OF MATERIA MEDICA. 



lungs The rational symptoms are: heat of the skin, 
accelerated and hardened pulse, difficult respiration, 
oppressing pain in the thorax, dry cough, tough, 
rusty expectoration. The physical signs are: dull- 
ness on percussion,, bronchial respiration, and on the 
margins of the dullness, fine crepitation. The patho- 
logical condition is: locally, a deposit of fibrine in 
the air-cells and tubes, consolidating the lung; and 
generally, a marked excess of fibrine in the blood. 
Now, the physiological school assumes this general 
pathological condition to be the essential cause of 
the disease ; to lie at the foundation of all its symp 
toms ; and it therefore proposes, as the method ot 
cure, to get rid of this pathological condition, viz., 
the excess of fibrine in the blood and the local 
deposit of fibrine in the lung. To accomplish this 
several means may be resorted to, which, though 
apparently different, are the same in principle. 
Blood may be abstracted from the arm. This 
will diminish the quantity of the circulating fluid, 
and thereby diminish the actual, although not the 
relative, quantity of fibrine. But as the quantity 
of the circulating fluid must always be the same, 
water is poured into the vessels from the surround- 
ing tissues or from the intestines, and thus the blood 
is really diluted. All other antiphlogistic or deriva- 
tive methods or medicines act in the same way. 
But does this method reach the real ultimate cause 
of the disease? By no means. In health the blood 
does not contain too much fibrine. How came it 
to do so in disease ? This leads us to the question : 



STUDY OF MATERIA MEDICA. 25 

Where is the fibrine manufactured, and how came 
so much to be made, or by what means is fibrine 
generally removed from the blood, and how happens 
it that it is not more rapidly removed ? To these 
questions the physiologists can return no certain 
responses as yet. But if they could do so, is it not 
obvious that in order that the blood should contain 
too much fibrine, there must have been either too 
much made or too little consumed. Now, if either 
of these be the case, how unwise to think of recti- 
fying matters by merely conveying away the surplus. 
It is like endeavoring to pump out a leaking vessel 
while the leak is still open. The pumping out is 
only a palliation, — can never be a cure. The cause 
of the disease must lie in the secretion of the fibrine. 
But this process is conducted, as you learn from 
the chair of physiology, through the agency of a 
structureless cell-wall, and by a process of which 
we know, and can know, absolutely nothing. It is 
an ultimate fact, a part of the fact of life. Such are 
all the ultimate causes of disease. And as diseased 
organic action is merely a modification of healthy 
organic action, as disease is only modified life, we 
can never hope to attain a knowledge of the real 
causes of disease, and can never base a therapeutics 
on the rational method of removing the cause. We 
must fall back, as all investigators of natural science 
have done, on an empirical science and an empirical 
law. 

The great majority, however, even of the old 
school of medicine, regard a therapeutic law as a 



26 



STUDY OF MATERIA MEDICA. 



great desideratum., as something essential to the 
constitution of medicine as a science. 

But to return to our patient. How shall we 
determine what drug to give him? We have prob- 
ably made a diagnosis, and given to the collective 
symptoms which he presents some name of a dis- 
ease, although, if we have much experience at the 
bedside we shall undoubtedly have remarked that 
though the same name may be given to a large 
number of apparently similar cases of sickness, yet 
in reality no two of them are in all respects alike ; 
indeed they often differ very widely. This is because 
the peculiarities of the individual patient are super- 
added to the general symptoms of the disease under 
which he is regarded as laboring. 

But. having formed our diagnosis and given a 
name to the case, we might recall from the annals 
of medicine a number of cases to which a similar 
name had been given, and which had been cured 
by such or such drugs. Now, there is a school 
of medicine, and it includes some very brilliant 
names, which teaches that such clinical experience 
as this is our only trustworthy source of thera- 
peutic knowledge, that we must gather up reports 
of cases and analyze them, find out what mode of 
treatment cured the greatest number of cases, and 
adopt this as the right mode. 

Louis, in Europe, and Bartlett and La Roche, 
in this country, are the representatives of this 
methodical or numerical school. 

Now, it will be easily shown, I believe, that 



STUDY OF MATERIA MEDICA. 27 

while this method may be better than nothing, 
while it may answer as a make-shift until some 
better be discovered, it is very far from being in any 
true sense a science of therapeutics. One objec- 
tion is this: Its aim is too low. It aims to cure 
only a majority of cases of any disease; for it avails 
itself of a method that succeeded only in a majority, 
not in all; it does not provide for the minority that 
were not cured by this favorite mode of treatment. 
It makes no provision for the investigation of the 
reason why it was that the mode in question failed 
in a certain number of cases, although it succeeded 
in a majority. And yet this failure could not have 
been accidental. There are no accidents in nature. 
There must have been some good reason for the 
failure, a reason to be ascertained by investiga- 
tion and so turned to account as to diminish the 
minority, and finally altogether to eliminate the 
failures. 

This point may be illustrated by example. If 
we gather the clinical records of intermittent fever, 
we shall find that a large majority of the cures 
recorded were effected by cinchona or its derivatives. 
The methodical school would therefore pronounce 
cinchona the cure for intermittent, still a minority 
of cases will be found which cinchona failed to cure. 
There must be a good reason for this failure, and 
a true science of therapeutics should make provision 
for the searching out and the finding of this reason. 
The science of the methodists makes no such pro- 
vision. The highest ideal of the methodists, then, 



2 8 STUDY OF MATERIA MEDICA. 

would be to cure a majority of the cases intrusted 
to them. This is too low an ideal to satisfy a 
reasoning creature. 

To find out this reason why cinchona, which 
cures so many cases, yet fails to cure other cases 
bearing the same name, one must evidently examine 
carefully the cases cured, on the one hand, and the 
cases which failed to be cured, on the other hand, 
in the hope of finding some traits of difference 
among the many features of resemblance. It will 
be found that such points of difference exist; that 
while the symptoms of chill, fever and sweat may 
exist in all, thus entitling all to the generic name 
of intermittent fever, there are, nevertheless, minor 
differences between the two classes of cases suffi- 
cient to make them quite distinct. Thus, for exam- 
ple, some cases have thirst, while others have 
none. Some have gastro-intestinal complications, 
while others have none. Or, complications of other 
organs or systems may exist. We thus see differ- 
ences in cases grouped under the same nosological 
name. But as yet this does not help us to a reason 
why cinchona should cure some of these cases 
and not others. And yet this is the very "pith 
and marrow" of the question. This is the all-im- 
portant question for solution. For it is obvious 
that if we could find out why cinchona ' cures cer- 
tain cases presenting certain symptoms, we should 
know with certainty whether to give cinchona 01 
not in a new case. We should have established a 
relation between cinchona or its properties and the 



STUDY OF MATERIA MEDICA. 29 

symptoms presented by cases of sickness. Such a 
relation is a law. We should then have discovered 
the great desideratum, the therapeutic law. What 
we seek to know then is this: What relation is there 
between the physiological action, the absolute 
properties of drugs, as ascertained by provings on 
the healthy subject, and the symptoms of disease? 
We have shown that the properties of drugs, in 
the sense in which we use the term, are accurately 
ascertained only by the symptoms they produce on 
the healthy subject. The question, then, may be 
expressed as follows : What relation subsists be- 
tween the symptoms which a drug produces on the 
healthy subject and those which it will remove 
from a sick man ? If we could answer this ques- 
tion, we should know what drug to select for our 
sick man, who has been waiting for a prescription 
while we have been discussing this subject. 

Very long ago, an answer was given to this 
question in the words : Contraria contrariis oppo- 
nenda, which means that the relation of contra- 
riety or opposition should exist between the symp- 
toms of the patient and the symptoms which the 
drug that we are to select to cure him is capable 
of producing. This was assumed to be the natural 
solution of the question. It was argued, and still 
is argued, that if a patient be heated, he seeks 
that which will cool him ; if thirsty, that which will 
make him not thirsty ; if constipated, a laxative ; if 
loose in the bowels, an astringent, etc., etc. 

The objection to this proposed law is twofold : 



o 0 STUDY OF MATERIA MEDICA. 

o 

1. It rests upon a confusion of ideas. The 
procedures of hygiene are confounded with those 
of therapeutics. In hygienic treatment the problem 
is to find out which of the natural general stimuli 
necessary to maintain health has been deficient or 
in excess or perverted, and to restore or regulate 
it. By this method, if there be too much heat, 
from this stimulus having been in excess, the 
obvious remedy is a diminution of the supply. If 
thirst spring from a too sparing supply of water, it 
is obvious that this must be made up, etc. And 
the test of a successful judgment in such cases is 
the cessation of the symptom. So in the case of 
constipation, if the impacted faeces act merely as 
a mechanical irritant, as a foreign body in the 
intestine, their removal by direct mechanical means 
or indirectly through an irritation produced in the 
intestine by drugs, is purely a hygienic procedure, 
and may be effected in accordance with the law 
Contraria cotitrariis. 

2. But when we come to symptoms which 
result not directly from abnormal supply of stimuli, 
but from a modification of the vital forces, and 
which consist in alterations of sensation, of func- 
tion, of tissue, how can we find the contraries, the 
opposites of these symptoms ? What symptom pro- 
duced on the healthy subject by a drug can be 
the opposite or contrary of a sore throat, of a 
gastralgia, of a toothache, of a miliary rash, of a 
delirium, of a nausea, of a small-pox pustule, of a 
scarlatina eruption, of a varicose ulcer ? 



STUDY OF MATERIA MEDICA. 31 

No more words are needed to show the ab- 
surdity of the maxim viewed in this light, — the 
impossibility of the proposed law. But it may be 
said that this interpretation does not do it justice. 
It may be urged that we are to seek not the con- 
traries of the symptoms themselves, but the oppo- 
sites of that physiological or pathological state 
which gave rise to the symptoms. 

In considering the subject from this point we 
shall be able to pronounce an opinion at the same 
time upon another principle of therapeutics, that 
indeed which is at the present day regarded with 
almost universal favor, — the method, it may be 
called, of treating diseases upon general principles. 

This method ignores any therapeutic law, its 
possibility or necessity. The reliance of this method 
is upon pathology, by means of which science it 
proposes to ascertain the interior changes in tissue 
and structure, which lie at the foundation of, and 
give rise to, the symptoms of the patient, and thus 
get a rational appreciation of the symptoms. It 
studies the symptoms produced by the drug in the 
same way. After having formed a theory of the 
conditions which produce these symptoms respect- 
ively, this mode of treatment proposes to select a 
drug capable of producing a pathological condition 
opposite or contrary to that which gave rise to the 
symptoms of the patient. 

Except in words, this method does not differ 
from that which we have discussed. Instead of 
opposing symptoms to symptoms directly, a theory 



^ 2 STUDY OF MATERIA MEDIC A. 

is formed respecting each series of symptoms, and 
these theories are opposed to each other. 

Using the word symptom as we do, in its broad- 
est sense, to include every fact that can be ascer- 
tained or observed by the medical practitioner, both 
objective and subjective, the symptoms of a patient 
comprise all that can be known respecting the 
patient's disease. To theorize upon the proximate 
or ultimate cause of these symptoms is not to add 
anything to our knowledge. It is indeed interpos- 
ing an hypothesis, the probable result of which will 
be to lead us astray. In no possible event can it 
facilitate the cure. 

Let us suppose a case: A patient presents a 
series of symptoms, among which paleness, palpi- 
tation, want of appetite, loss of strength, perhaps 
haemorrhage from various surfaces, are prominent. 
These, with the other symptoms, furnish all that 
can be ascertained about this patient. Physiology 
and pathology enable us to comprehend how these 
symptoms are connected with each other, and with 
certain states of the solid and fluid tissues of the 
body ; and thus these sciences enable us to form a 
diagnosis and a prognosis and to institute a hygi- 
enic treatment. But when we come to therapeutics, 
if we adopt the method of treating on " general 
principles," we shall say, the blood is deficient in 
red globules, hence the paleness and palpitation. 
The serum is in excess, hence the anasarca 
and the loss of strength. There are laxity and 
flaccidity of the surface membranes, and of the 



STUDY OF MATERIA MEDICA. 33 

muscles and nerves, hence the haemorrhages and 
the debility. 

The indication is to give a remedy which will 
increase the red globules and will give tone to 
membranes, muscles and nerves. 

This sounds wise and practical. But on analysis 
it proves to be mere verbiage. The pathological 
statement is a mere restatement of the symptoms, 
adding nothing to their force or significance. 

The indication may be reduced to this simple 
general indication : Give a drug that will cure the 
patient, — a thing we all wish to do. We know of 
no drug that will, in the healthy subject, increase 
the red globules of the blood ; nor can we ever 
know a drug that will give tone to the healthy 
membrane, muscle and nerve. For what do we 
mean by tone? Nothing more nor less than 
healthy normal condition. Can any drug ever pro- 
duce this condition in a healthy subject? Can we 
reproduce what is already in active existence ? 
It is manifest, then, that this method is, after all its 
parade of science, its pathological analysis, its 
indication, and its appeal to general principles, 
nothing- else but the raw and crude resort to unmeth- 
odized, empirical experience. Iron, which in the case 
supposed, would of course be the drug selected, 
will in reality be chosen, not because its symptoms 
sustain, or their hypothetical, pathological cause 
bears, any relation of contrariety to the symptoms of 
the patient or their hypothetical, pathological cause ; 
but solely because it was found out in some man- 

4 



34 STUDY OF MATERIA MEDICA. 

ner unknown that iron would cure such cases ; and 
manifold experience has corroborated the discovery. 
Just as it was found out that cinchona would cure 
intermittent fever and mercury syphilis. The fact 
that iron cures the case, and that iron is a constit- 
uent of the red globule, is a mere curious coinci- 
dence. But unless a law should be induced from 
such experience, we have shown that the experience 
alone cannot serve as the basis of a science of 
therapeutics. 

It is clear, then, that the relation between the 
symptoms of a disease and the symptoms of the 
drug that will remove them, cannot be that of con- 
trariety or opposition. 

How may we ascertain what it is if indeed 
there be any fixed relation ? 

If we had no knowledge of any drugs that 
almost uniformly cure certain diseases, it would be 
almost impossible to find an answer to this ques- 
tion. But, fortunately, we possess several drugs of 
which we know by long and often-repeated expe- 
rience, indeed by common consent, that they do 
cause the disappearance of certain definite groups 
of symptoms. Now, is it not probable that if we 
avail ourselves of these facts, and if we prove some 
such drug upon the healthy organism, and compare 
the symptoms thus produced by it with the symp- 
toms which we know it to be capable of curing, 
we shall thus at last, "after a number of such trials, 
arrive at a knowledge of the relation which exists 
between the symptoms which a drug can produce 



STUDY OF MATERIA MEDICA. 35 

on the healthy, and those which it can remove in 
the sick? This relation, if constantly observed, 
would serve as a therapeutic law. For, by provings 
upon the healthy we have it in our power to 
ascertain the symptoms which every drug is capa- 
ble of producing. We can have thus an armament 
in reserve to meet any symptoms that may present 
themselves in a patient. And there is no limit to 
the extent to which this may be carried. 

Now, this has actually been done with respect 
to all the well-known and conceded specific medi- 
cines, and indeed to nearly all known drugs. It 
has been observed that a constant relation exists 
between the symptoms which a drug will produce 
in the healthy subject and those which it will cure 
in the sick. This relation is that of similarity. 

It is not necessary to adduce at this time 
instances in corroboration of this statement. They 
will occur during every lecture of this course when 
we come to the study of individual drugs. 

From the fact of this constant relationship of 
similarity springs the therapeutic law which I believe 
to be the universal and only one, — Similia simih- 
bus cnrantur. Diseases are to be cured by drugs 
which are capable of producing in the healthy sub- 
ject symptoms similar to those of the disease in 
question. 



36 



The homoeopathic materia medica is made 
up, theoretically at least, of the objective and sub- 
jective symptoms produced upon healthy persons 
by drugs, taken with a view to ascertain their 
physiological or pathogenetic effects. I say the- 
oretically, because our materia medica being as 
yet incomplete and imperfect, whereas the exigen- 
cies of practice are as wide and various as the 
distribution and the diseases of the human race, 
we are under the present necessity of supplement- 
ing our pure provings by observations of the action 
of remedies on the sick (called clinical symptoms), 
by toxicological records which are involuntary prov- 
ings made in a rougher way than we could desire, 
and even by hypothetical conclusions from the 
scanty data of incomplete provings, as, for exam- 
ple, when from the action of a drug upon the 
mamma we infer its effect upon the ovary, etc., etc. 
The necessities for the temporary expedients will 
be less frequent in proportion as we are able to 
carry forward the development of the science of 
materia medica. This is a work which requires 
much time, labor and self-sacrifice of those who 
engage in it, and several generations must pass 



37 



away before the science will have attained tolerable 
completeness. Were it never so complete, we are 
called upon to deal with bedside problems that 
would severely tax its resources. And we are com- 
pelled to base our prescriptions frequently upon 
clinical observations, upon analogies, upon some 
trivial symptoms in some region of the body quite 
remote from the pathological center of the disease; 
certainly such cases as these most brilliantly illus- 
trate the value of our grand therapeutic law, which 
leads us to success through many dark places on 
which pathology would shed no light. Neverthe- 
less, as students of science we cannot but desire 
that our materia medica should be as complete, and 
should present us pictures of drug diseases, as 
numerous and varied as the maladies for which we 
are called to prescribe ; as workers in the domain 
of science, we cannot but determine to give our- 
selves to this task of developing the materia medica. 
It behooves us then to examine our present 
materia medica, and mark where it is weak and 
defective, that our earnest efforts may be given first 
to those points. Before specifying some of these 
points, let me speak for a moment of others on 
which I think the materia medica is strong, since 
by these we may exemplify the characteristics of a 
serviceable pathogenesis. 

I consider that in its account of the action of 
drugs upon the alimentary canal as compared with 
other regions, the homoeopathic materia medica is 
reasonably complete and definite. As regards the 



38 



stomach, the symptoms of drugs are, in general, so 
clearly stated that we can distinguish, as Dr. Hir- 
schel has shown in his prize essay on cardialgia, 
the neuroses from the various organic affections, 
and in each of these departments it is not often 
necessary to hesitate long in the selection of the 
remedy. 

If this be true of the stomach, it may be still 
more emphatically stated of the lower portions of 
the alimentary canal. Among the points upon 
which the symptoms of the materia medica give 
data which enable us to distinguish the indications 
of one drug from those of another, may be named: 
the sensations and pains, both those felt by the 
patient irrespective of his actions, and such as are 
induced by motion, touch, etc. ; second, perform- 
ance of function ; third, contents of the intestine, 
as evidenced by evacuations ; fourth, symptoms 
attendant upon evacuation. 



THE THERAPEUTIC LAW. 



ANALYSIS. 



H istory — Dcfin it ion — Empirical, requiring evidence — Evidence fur- 
nished by physiological and therapeutic effects of drugs, and 
to be given, in extenso, pn the course of the lectures on 
special drugs — Practical application of the law — // involves 
a twofold study, each branch of which may be a distinct 
and independent study, viz. : i. Study of the phenomena 
of natural disease, and 2. Study of the phenomena of 
the action of drugs on the healthy subject — These studies 
must be empirical and positive, recognizing onlv facts and 
disregarding hypotheses — Symptoms in the broad sense the 
only object of study — Similarity being the object of our 
search, cases are to be individualized, and nosologies to be 
disregarded — Each case studied in and for itself — Same 
with diseases and pathogeneses — What are symptoms? — ■ 
How are physiology and pathology to be employed? — Varie- 
ties of symptoms — Generic, specific, characteristic — The same 
of diseases as of drugs — What is a proving? — How to 
study a drug. 



HE last lecture concluded with a statement of 



law; that commonly expressed by the words "Sim- 
ilia similibus curantur" or, "Sick, persons are to 




I regard as the universal 





4<D THE THERAPEUTIC LAW. 

Adherence to this law as the universal law of 
cure is distinctive of the homoeopathic school of 
medicine. Nevertheless, the statement of the law 
did not by any means originate with Hahnemann, 
the founder of homoeopathy ; nor is the acceptance 
of the law as a law of cure confined to homceo- 
pathicians. Many most distinguished physicians of 
the old school, as Pereira, Watson, Trousseau, 
Bouchut, and many others, accept it as a law of 
cure, of wide application, although they deny its 
universality. I believe their denial springs from a 
confusion in their minds between the procedures of 
hygiene and therapeutics. The law was clearly 
expressed in a very remarkable passage of a work 
ascribed to Hippocrates. Paracelsus had a glimpse 
of this truth, and expressed it in his quaint and 
mystical fashion; and in so far as the imperfect 
state of the materia medica allowed, it is believed 
that he practiced in accordance with it. " Stoerck 
was struck with the idea that if stramonium dis- 
turbs the senses, and produces mental derangement 
in persons who are healthy, it might very easily 
be administered to maniacs for the purpose of 
restoring the senses by effecting a change of 
ideas." (Hahnemann's u Organon," 4th American 
Edition, p. 76.) This was a perception of a partic- 
ular instance, but not of the general law. 

Stahl expresses himself as follows: "The 
received method in medicine, of treating diseases 
by opposite remedies — that is to say, by medi- 
cines which are opposed to the effects they pro- 



THE THERAPEUTIC LAW. 4! 

duce (contraria contrariis) — is completely false and 
absurd. I am convinced, on the contrary, that 
diseases are subdued by agents which produce a 
similar affection (similia similibus) ; burns by the 
heat of a fire to which the parts are exposed; the 
frost-bite by snow or icy-cold water; and inflam- 
mations and contusions by spirituous applications. 
It is by these means I have succeeded in curing 
a disposition to acidity of the stomach by using 
very small doses of sulphuric acid in cases where 
a multitude of absorbing powders had been admin- 
istered to no purpose." 

This was written in Denmark in 1738, nearly 
fifty years before Hahnemann's first publication on 
the subject. It is a distinct statement of the law. 

Hahnemann, who was a very learned man and 
a very highly educated physician, became, early in 
his practice, deeply and painfully convinced of the 
great uncertainty of medical science as it was then 
taught and practiced, and of the serious injuries 
that were often inflicted on the patients by the 
improper use of drugs. He fully indorsed the say- 
ing of his predecessor, Girtanner, that " the doctor 
with his drugs is like a blind man with a club. 
He aims to crush the disease, but is quite as likely 
to destroy the patient." Hahnemann was by no 
means singular in this view of actual medical 
science. Most of his contemporaries agreed with 
him. And from his day to the present, eminent 
physicians of the old school have expressed similar 
convictions. What fruits did this conviction bear? 



42 



THE THERAPEUTIC LAW. 



It is related of Sir Isaac Newton that when asked 
to account for his transcendent genius and its won- 
derful achievements, he modestly replied that it con- 
sisted in nothing but this: that he had a little more 
patience and perseverance than some other men. 

So Hahnemann, when convinced of the uncer- 
tainty and unsafeness of the medical science of his 
day, rested not in his search for something more 
safe and sure. " He that seeketh shall find." To 
the receptive, eager mind, a trivial incident may 
serve as the clue to a brilliant discovery, just as 
the falling apple did in Newton's case and the 
swinging chandelier in Galileo's. 

Hahnemann, having taken a dose of tincture 
cinchona, observed the symptoms which resulted 
from it. He was struck with their similarity to the 
symptoms of an attack of intermittent fever, from 
which he had suffered years before. He knew that 
cinchona was the great specific for intermittent 
fever. The question at once occurred to him, Can 
it be that this similarity is a mere coincidence in the 
case of this particular drug and the disease which it 
cures, or is it an example of a general law of nature? 
If it be indeed a general law of nature, may it not 
be the great therapeutic law of which we are in so 
great need ? Up to this point of perceiving or 
suspecting the law, Similia similibus curantur, 
Hahnemann had been preceded, as he very well 
knew and openly stated, by Hippocrates, Stoerck 
and Stahl, and others. They, however, contented 
themselves with throwing out the intimation or con- 



THE THERAPEUTIC LAW. 



43 



jecture and abandoning it. Not so Hahnemann. 
He argued : if this be a general law, it is capable 
of demonstration in two ways : 

1. A posteriori, — by searching and analyzing 
the records of medicine, — a task which he forthwith 
undertook with great success, and, 

2. A priori, — by the direct experiment, — by 
ascertaining the effects of some drugs on the 
healthy subject, and then giving them to sick peo- 
ple whose symptoms happened to be similar to 
those which the drugs had produced. 

By experiments and observations of these kinds, 
carried on for twenty years, Hahnemann satisfied 
himself of the truth of the law. The points of evi- 
dence will be laid before you when we study the 
different drugs of the materia medica. 

But now, please take notice that this law 
requires that the sick person shall receive a drug 
which is capable of producing in the healthy sub- 
ject symptoms similar to those of the patient. This 
law can never be applied in practice unless we 
possess a materia medica which contains a record of 
the symptoms which drugs produce in the healthy. 
No such materia medica existed in Hahnemann's 
day. All that there was, was a mere record of 
the effects upon the sick, and of hypotheses and 
guesses. Now came into operation that infinite 
patience and that perseverance which mark tran- 
scendent genius. Hahnemann undertook the Titanic 
labor of creating this indispensable materia medica. 
Proving more than a hundred drugs upon himself 



44 THE THERAPEUTIC LAW. 

and his friends, subjecting himself thereby to toil 
and suffering indescribable, he compiled for us the 
" Materia Medica Pura," in six volumes, and the 
" Chronic Diseases," in five volumes, — an imperish- 
able monument to his genius and self-devotion. 

This materia medica, founded by Hahnemann, 
and enlarged and enriched by the labors of his 
successors and by the addition of all that is trust- 
worthy in ancient or contemporary literature, is our 
treasury of knowledge of the action of drugs upon 
the human organism. 

You will observe that the therapeutic law we 
have laid down speaks of two classes of symptoms: 

1. Those of the patient; and, 

2. Those produced in the healthy subject by 
a drug. If the latter be similar to the former, then 
the drug which produced the latter will remove the 
former. 

This statement points to two subjects for our 
study, — the symptoms respectively of sick persons 
and of drug-provings. 

The law, it will be noticed, is empirical. It is 
based on no theory of the action of drugs, and it 
involves no theory whatever. It merely states that 
a coincidence has been observed to exist between 
the symptoms which a drug will cause in the 
healthy and those which it will remove in the sick. 
In this respect it is analogous to the laws of grav- 
itation and of chemical affinity, and in definite 
proportions indeed to the great central laws of all 
the natural sciences. 



THE THERAPEUTIC LAW. 45 

In like manner the studies of the two classes 
of symptoms to which the law points us, are to be 
made in a positive and empirical manner ; and we 
are to take care that no hypothesis respecting the 
nature and ultimate cause of the symptoms which 
we observe in the sick, be allowed to come in and 
modify or pervert our pure observation. 

In order to apply the therapeutic law in the 
treatment of disease, we have then to study, 

1. The symptoms of patients; and, 

2. The symptoms of healthy persons who have 
taken drugs for the purpose of ascertaining their 
effects. 

These studies are similar in their character, but 
they are wholly independent of each other, and 
may be pursued separately ; indeed, are only con- 
joined when the object of the study is to be quali- 
fied to practice the art of curing. This being one 
object, we cannot do better than devote some 
time to an investigation of the modes of studying 
symptoms. 

By a symptom of disease, whether it be a nat- 
ural disease or a diseased state produced upon 
himself intentionally by a prover of drugs, we mean 
any deviation from a normal condition in any organ 
or function of the body, which deviation is capable 
of being observed by the physician or by the 
attendants, or by the patient himself. The senses 
of the observers may be assisted by any imple- 
ments or processes, such as the stethoscope, the 
microscope, the ophthalmoscope, chemical analysis, 



46 THE THERAPEUTIC LAW. 

etc., etc. If every function of the body be per- 
formed in a proper, healthy manner, there can of 
course be no symptoms of disease. If any function 
be not performed in a proper, healthy manner, the 
facts by which we perceive and which enable us to 
know that this is so, are the symptoms of the case. 
We sometimes hear of the existence of latent dis- 
ease of which no symptom exists. This may be, 
but its existence is only hypothesis, and is after- 
ward inferred from the subsequent occurrence of 
symptoms. To detect its existence when thus latent 
would be impossible, for if it gave in any way the 
least token of its existence, that token would be a 
symptom. 

Symptoms may be objective or subjective. Ob- 
jective symptoms are those which are observed 
and taken note of by the physician or by the 
attendants of the patient. They could be observed 
whether the patient were conscious or not. The 
aid of his intelligence is not invoked in gaining a 
knowledge of them. They are the color, texture, 
temperature of the skin and membranes, the 
expression of the eyes and features generally, 
position, motions and attitudes of the body, secre- 
tions and excretions of glands and surfaces ; in 
short, objective symptoms comprise everything 
which the physician can take cognizance of in the 
sick man, by the aid of his five senses assisted or 
unassisted. Physical and chemical and microscopic 
analyses are included. Subjective symptoms are 
those of which we get a knowledge through the 



THE THERAPEUTIC LAW. 47 

medium of the patient's own intelligence and tes- 
timony. They comprise the various sensations, 
pains and abnormal feelings, the infinite variety of 
unwonted thoughts, emotions, sentiments, dreams 
and visions which diversify the existence of the 
sick man. If the patient be ill of a disease which 
makes him stupid or unconscious, we cannot get 
any subjective symptoms, — as in typhoid fever some- 
times. If he be delirious we have to receive his 
expressions with due caution. 

To these varieties of symptoms must be added 
a third, which modifies the former, viz., the symp- 
toms comprised in the previous history of the case. 
These will show us any constitutional taint or 
miasm in the patient; and by teaching us his 
habits and idiosyncrasies may often enable us to 
decide how much weight to attach to one or 
another subjective or objective symptom. 

We have thus briefly described the classes of 
symptoms. The law requires us. to compare the 
aggregate of symptoms presented by the patient 
with the symptoms produced by drugs that are 
known to us ; and to select for the case the drug 
of which the symptoms are most similar to those 
of the patient. It is objected to this very empiri- 
cal and almost mechanical method, that it takes no 
account of the causes of symptoms, does not under- 
take to trace them to their causes ; that it entirely 
ignores physiology and pathology, sciences which 
have thrown so much light on the nature and 
causes of disease ; that it exposes the prescriber to 



48 THE THERAPEUTIC LAW. 

the hazard of making great errors, inasmuch as the 
same external symptoms may be clue to very dif- 
ferent internal causes; and finally, that it virtually 
makes out disease as consisting of an aggregate of 
external symptoms, whereas it is universally con- 
ceded that disease exists by virtue of an internal 
dynamic cause, no less a cause than a deranged 
condition of some of the vital forces or susceptibil- 
ities. 

Now, I hold strictly to the therapeutic law. I 
maintain that, viewed from the stand-point of the 
prescriber, the aggregate of the symptoms does 
constitute the disease. That in no other way than 
by selecting his drugs in strict accordance with the 
similarity of the symptoms, can he so surely pre- 
scribe accurately, and cure his patient quickly. 
Nevertheless, I shall endeavor to show you that 
this adherence to the law is by no means equiva- 
lent to a declaration that the symptoms are really 
the disease ; I shall show you that we are in no 
danger of confounding different diseases — misled by 
a similarity of their symptoms — if we strictly follow 
the law. And then, if I do not show you as we 
proceed in our course, that for the proper study of 
symptoms before we get ready to prescribe for our 
patient, we have need of and must employ our 
knowledge of physiology and pathology to the 
utmost extent of our resources, bringing every 
auxiliary medical science to bear on our study 
of symptoms, I shall submit to be offered a sacri- 
fice to the offended divinities of these respectable 



THE THERAPEUTIC LAW. 



49 



sciences — auxiliary merely and subsidiary as they 
are to the great practical end and aim of medi- 
cine, the application of drugs to the cure of the 
sick. 

The symptoms which a patient presents do not 
constitute the essence of the disease; they are not 
the disease itself, they are only a result of the 
disease. This we freely admit. We have already 
stated that the essential nature of the disease is to 
be sought in a modification of that mysterious 
property of the organic cell-walls, by virtue of 
which the respective organs of the body perform 
their functions. In the healthy body we know 
nothing of the nature of this property or vital 
force. We should not know of its existence were 
it not for the functions which, by virtue of its 
exercise, the organs of the body perform. But 
in like manner, we should not know that the 
action of this mysterious force was perverted in 
disease, were it not that in consequence of its per- 
version the functions of the organs of the body 
are performed in an abnormal manner. But the 
abnormal performance of its function by any organ 
of the body constitutes a symptom of disease. It 
is, therefore, from the existence of symptoms of 
disease that we argue the existence of disease. 
Per contra, if no symptoms of disease present 
themselves to our scrutiny, we cannot know that 
disease exists. It is, therefore, strictly correct to 
say that we recognize the existence of disease only 
through the existence of its symptoms. It is man- 
5 



tjo THE THERAPEUTIC LAW. 

ifest, then, that if we can cause the permanent 
cessation and disappearance of symptoms we shall 
have effected an annihilation of the disease, in so 
far as it is possible to judge of this matter. And 
it follows that the declaration that the aggregate of 
the symptoms is, from the practical stand-point, 
equivalent to the disease, is correct, because, the 
aggregate of the symptoms being permanently 
removed, we are justified in assuming that their 
cause has been removed. 

It has been objected to the mode of prescribing 
which the law, Similia similibus curantur, enjoins, 
that it is a prescribing for the symptoms and not 
for the disease. This is not a fair criticism. The 
symptoms are our guide in selecting the remedy. 
It does not follow that they are the object of our 
prescription. This no more follows than it follows 
that because a traveler in a strange road goes from 
guide-post to guide-post, from mile-stone to mile- 
stone, therefore the guide-posts and mile-stones are 
the object of his journey, that his sole purpose is 
to find and come up with one after another of 
these useful indicators, these symptoms that he is 
on the right road. 

The objection of which we are speaking, viz., 
to the treatment of symptoms, is well grounded 
only in cases where one or a very few symptoms 
are taken as the basis of the prescription, while 
the remaining symptoms are ignored. Where this 
is done, we often see deplorable mistakes commit- 
ted. A remarkable instance of this is furnished by 



THE THERAPEUTIC LAW. 



51 



a celebrated surgical case. When Mr. Perceval 
was shot, as he came out from the House of Com- 
mons, being mistaken for Sir Robert Peel, he came 
under the care of the celebrated surgeon, Mr. 
Guthrie. The wound was of the thoracic walls. 
The public interest in the case was very great. 
Daily bulletins were required^, and were issued. 
Mr. Guthrie reported that his patient's wound was 
doing well and that his prospects of recovery were 
excellent. One day, after such a report, the 
patient died; and it was discovered at the autopsy 
that he died of empyema (or pus in the cavity of 
the pleura). How came Mr. Guthrie to blunder so 
terribly? Why, it was exp 1 ained in this way. His 
specialty being surgery, he had confined his atten- 
tion to the wound and had overlooked the symp- 
toms of pleuritis which had no doubt been present 
for a number of days, obvious to whomsoever had 
eyes to see. To give this case as an instance of 
the impropriety of judging and prescribing accord- 
ing to the symptoms of a case, is to lose sight of 
the fact that our law requires that the aggregrate 
or totality of the symptoms be made the basis of 
the prescription. This is the all-important point. 

Not only will care in this respect prevent our 
overlooking and failing to meet the real nature of 
the case ; but it will obviate another objection 
which is raised against a prescription based on the 
symptoms, to wit: that the same symptom may 
depend upon any one of several morbid states, and 
that therefore we may be led to adopt a mode of 



52 



THE THERAPEUTIC LAW. 



treatment very suitable for one form of disease 
that often presents the symptoms before us, while 
in reality a very different disease is at the founda- 
tion of the symptoms of the case in hand. We 
admit this to be true of isolated symptoms or 
groups of symptoms, but we deny that it is true 
of aggregates of symptoms. The same aggregate 
or totality of symptoms can be produced only by 
the same morbific cause, acting in the same manner 
and direction. Were it otherwise, it would be 
impossible to distinguish between the two causes, 
since these imponderable causes are recognized 
only by their effects, the disease only by the total- 
ity of its symptoms. 

This position should be illustrated by examples. 
The disease known as acute hydrocephalus has 
well-marked symptoms, indicating first, inflamma- 
tion of the meninges of the brain, and then effusion 
with its resultant symptoms of oppression. 

Now there is an affection, which is pathologi- 
cally of a precisely opposite character, and which 
is not unfrequently met with, the hydrocephaloid 
affection described by Marshall Hall. The signs 
of irritation in the first stage and of oppression in 
the second stage, are so very similar to those of 
hydrocephalus acutus, as to deceive all but the 
most wary practitioners. Yet the symptoms of 
hydrocephalus acutus result from a true inflamma- 
tion of the meninges of the brain, while those 
of the hydrocephaloid affection depend altogether 
upon a depressed state of the vegetative system, 



THE THERAPEUTIC LAW. 



53 



in fact upon a starved condition of the organism, 
caused by either a too severe antiphlogistic course 
of treatment, or a too abstemious regimen during 
some general disease (not cerebral). The patho- 
logical difference is world-wide. The difference in 
the symptoms, so far as the brain symptoms are 
concerned, is hardly perceptible. Yet it is of the 
utmost importance, so far as the treatment is con- 
cerned, that these affections should be clearly 
distinguished. How shall it be done? Why, if 
we confine our attention to the brain symptoms 
alone (and a careless writer calls these the impor- 
tant symptoms), to the symptoms of that organ 
which seems to be chiefly affected, I hazard nothing 
in saying that the distinction cannot be made and 
the treatment cannot be judiciously selected. 

But we have repeatedly stated that the aggre- 
gate of the symptoms, the totality of the symptoms, 
is to be regarded. Now, in this aggregate or 
totality are included not merely the brain symptoms, 
but likewise all other symptoms, and not merely 
the present state but also the past history or anam- 
nesis of the patient. If we turn from the cerebral 
symptoms to the history and to the other symp- 
toms of the patient, we shall find that whereas in 
the case of true hydrocephalus there is a hard, full, 
and rather frequent pulse with evident inflamma- 
tory fever, and the disease has come out from a 
state of tolerable, sometimes of what is called 
"ruddy," health ; in the other affection the pulse is 
small, or, if full, is very soft, infrequent and irreg- 



54 



THE THERAPEUTIC LAW. 



ular, the skin is cool, and the history of the 
patient discloses that the affection is always a 
sequel of some acute and exhausting malady, quite 
frequently of some one of the exanthematous 
fevers. Thus, a study of the totality of the symp- 
toms rescues us from the danger into which we 
might fall from a study of a few prominent symp- 
toms only, — the danger, namely, of confounding 
one disease with another, and of thus forming 
and adopting an erroneous plan of treatment. 

Now, while these remarks are fresh in your 
minds, let me ask you to notice these facts. The 
example just cited shows you that while observa- 
tions of symptoms may be correct, yet the conclu- 
sions drawn from them when we reason upon 
them may be altogether erroneous; and a treat- 
ment based upon this reasoning would of course 
be injudicious. Now, if we can base our plan of 
treatment directly upon the aggregate of the symp- 
toms, without the interposition of a course of 
reasoning which may or may not be erroneous, 
but which is always liable to be false, shall we 
not be much more sure of success ? 

Another instance of an error in treatment from 
the exclusive observation of a few symptoms and 
the neglect of the aggregate, is so common among 
old-school practitioners that I may do you a ser- 
vice in mentioning it. 

Young girls who have just become young 
women, and have grown rapidly, and have been 
perhaps assiduous at school, often complain of dys- 



THE THERAPEUTIC LAW. 55 

pncea, of stitch in the side, of a slight cough, of 
lassitude. Their complexion may be very fair and 
a high color may give brilliancy to their cheeks, 
particularly in the afternoon. The doctor is called. 
The chest is the part complained of, and so he 
addresses his power of observation to the chest. 
He observes dyspnoea ; ah ! that shows infiltration 
in the air-cells ; cough, irritation of the mucous 
surface ; stitch in the side, circumscribed pleurisy 
of course ; heightened color in the afternoon, what 
can this be but hectic ? No more is needed to be 
looked for or asked about. He diagnosticates at 
once tuberculous deposit, inflammation around it, 
and incipient phthisis. Now is the very time for 
antiphlogistic measures, that we may nip it in the 
bud. Accordingly, if the doctor be of the very 
old school, he bleeds; if not so very old, he depletes 
in some less obvious, less sanguinary manner. But 
the patient does not improve. She grows steadily 
worse. If I had not very frequently seen such 
cases, were not indeed in the habit of seeing them, 
I should not venture to give such gross instances 
of error from forming a judgment on the basis of 
a few symptoms only. In truth, there is no tuber- 
culosis, no inflammation about these cases. If the 
doctor had studied the totality of the symptoms, 
he would have found in the history of the case a 
fine state of health, gradually impaired by too 
close application at school ; menstruation free and 
frequent, gradually diminished in quantity and 
frequency, and deteriorated in quality ; the stitch 



56 THE THERAPEUTIC LAW. 

in the side not, like that of pleurisy, aggravated by 
motion and pressure, but actually relieved by exer- 
tion in the open air; the supposed hectic no such 
thing, the pulse being actually at that time small, 
and though frequent, yet very soft and compressi- 
ble, and the lungs, on percussion and auscultation, 
normal, showing that there can be no deposit in 
them. In addition to all this there will be a 
change in , temperament and disposition, a timid, 
despondent, sighing and longing disposition, which 
makes the patient melancholy, prone to tears and 
easily discouraged, the very reverse of that which 
characterizes incipient phthisis. These symptoms 
all taken together clearly indicate the remedies 
required, if indeed any be needed. I express this 
doubt, because often a mere change of diet, regi- 
men and associations will work the desired cure ; 
while the • antiphlogistic treatment, by rendering 
still more serious the existing debility, may induce 
the very state of things which, under an errone- 
ous diagnosis, it supposes to exist and seeks to 

remove. 
1 

Be never content, then, to prescribe without 
carefully collecting and studying the totality of the 
symptoms. 

We know nothing about life, except through its 
manifestations in the functions of the living organ- 
ism. Disease has been defined as modified life. 
Whatever life may be, disease is the same thing 
modified so as to have become abnormal. As life 
is known only through its manifestations, so can 



THE THERAPEUTIC LAW. 



57 



disease be known only through its manifestations, 
which are the perverted functions of organs or the 
modified and altered tissues of the body. But we 
cannot have any knowledge of, or ability to recog- 
nize, a perverted function unless we be familiar with 
the healthy or normal function. We cannot recog- 
nize a changed or diseased tissue unless we be 
familiar with the healthy tissue. But we derive a 
knowledge of healthy tissue through the science 
of anatomy, and of healthy and normal functions 
through the science of physiology. It is, therefore, 
I think, a logical necessity to admit that we cannot 
recognize and study symptoms which are the mani- 
festations of disease unless we be familiar with 
anatomy and physiology. 

It is clear, then, that no matter in what way 
we may propose to use our symptoms in 
making a prescription, whether we compare them 
directly with those of drugs in order to find a 
simile, or whether we use them as the basis of 
theory, in correspondence with which we are to 
prescribe "on general principles," — it is clear, I 
say, that we cannot recognize nor obtain our 
symptoms without the aid of physiology. 

Furthermore, we are to get the totality of the 
symptoms. So numerous are the organs of the 
body, so complex their functions, so intimate their 
relations to each other, so various their mutual 
reactions, that unless we follow some guiding 
method in the examination of the patient, we shall 
be in great danger of letting some symptom, or 



58 



THE THERAPEUTIC LAW. 



group of symptoms, obscure perhaps but all 
important, elude our vigilance. 

Now, the relations of different organs of the 
body are so intimate, that when the functions of 
certain organs are altered it invariably happens 
that certain other organs likewise are affected. A 
knowledge of such facts as these affords us incal- 
culable aid in getting at the true state of our 
patient, and it is indispensable. Knowledge of this 
kind belongs to the science of pathology which 
treats of the perverted functions and relations of 
the diseased organism. 

Again, the function of an organ may be so 
modified as that, under certain conditions and cir- 
cumstances, this modification must be regarded as 
a symptom of disease, while under other conditions 
it should not be so regarded. An enormous appe- 
tite which, under ordinary circumstances, would be 
a symptom of disease, might, during convalescence 
from a typhoid fever, be looked upon as not 
abnormal in any degree. So, too, of the cough in 
hypostatic pneumonia. So, likewise, of many alter- 
ations of taste and appetite, e. g., for fruit at the 
close of rheumatic fever. But with the significance 
of the functions of the organism under various 
circumstances it is the special province of pathol- 
ogy to deal. 

We perceive, then, that without the aid of 
physiology and pathology, we are utterly unable 
to recognize and to discriminate and estimate 
symptoms. 



THE THERAPEUTIC LAW. 



59 



Now, I think, with these points settled, we 
may pass with quiet confidence to the practical 
question: How shall we study and arrange this 
totality of the symptoms, so as to make a pre- 
scription in accordance with it? 

The therapeutic law requires us to select a 
drug of which the symptoms produced on the 
healthy are most similar to those of the patient. 
It appears, then, that we are to make a compari- 
son between the aggregate of the patient's symp- 
toms and the symptoms of the drugs in the 
materia medica, in order that we may find among 
these drugs that one drug of which the symptoms 
are the most similar. It is probable — indeed we 
well know — that the symptoms of a large number 
of drugs may present some similarity to each other 
and to the case in hand. A few will be very 
similar, and it may be very difficult to select from 
these that one which is most similar. The spirit 
of the whole process is evidently one of individual- 
ization. We take groups of drugs and analyze the 
symptoms they present, and select the one or the 
few that seem similar, and if there are several we 
analyze again, and select from among these that 
one which is the most similar. The process is the 
reverse of generalizing. 

It is evident that for the convenience of this 
process, through which the prescriber must go at 
each prescription, drugs will naturally divide them- 
selves into groups, the members of which resemble 
each other pretty closely, but which, nevertheless, 



60 THE THERAPEUTIC LAW. 

may be distinguished from each other, and from 
all others by a few symptoms. Now, the symptoms 
which the members of these groups have in com- 
mon are generic symptoms. These symptoms 
could never enable us to select the remedy, but 
they would point out to us a group of drugs, all 
of which possess these symptoms; and all of which 
are therefore tolerably similar ; but which of these 
is most similar, we can only ascertain by rinding 
some symptom or collocation of symptoms possessed 
by that drug alone, and which serves to distinguish 
it from all other drugs. Such symptoms are what 
are called characteristic symptoms, and are of the 
greatest importance to the prescribes 

They are different from those symptoms which 
the diagnostician would call characteristic, and which 
are pathognomonic symptoms. 

Our next lecture will be on Aconitum napcllus. 



PRELIMINARY OBSERVATIONS. 



DR. HERING has very happily explained that 
Hahnemann called his materia medica "pure," 
not as claiming that it is "spotless" or faultless, 
but that it is "free from fiction," from preconceived 
theory, from hypothetical notions ; that it embodies 
the result of the pure observation of phenomena 
produced by drugs upon the healthy organism. 

Such is our materia medica, — a record of actual 
occurrences, of events that really took place, of 
results that were unquestionably produced upon 
the healthy subject. It can never grow obsolete. 
Theories may be originated, may flourish and grow 
antiquated, and at last fade into oblivion. The 
hypotheses that constitute the science of pathology, 
after passing current for a generation or two, are 
sure to be rejected in favor of some newer issue, 
and the very terms in which they are expressed 
may become unintelligible as time goes on. But 
the facts of our materia medica, expressed in the 
ever-comprehensible vernacular language, are always 
fresh. Being the results of pure observation, and 
therefore absolutely true, no modifications in phi- 



62 



PRELIMINARY OBSERVATIONS. 



losophy, no changes of theory, can supersede them. 
Our materia medica is an ever-enduring work. 

It is of the utmost importance that it should 
always retain this quality of "purity," this freedom 
from fiction and from hypothesis. Very justly, 
therefore, do the leaders of our school denounce 
and discourage all attempts to incorporate into the 
materia medica speculations upon the modus ope- 
randi of remedies, and inferences, concerning the 
diseases which they may be likely to cure. 

But we, whose business it is to encounter dis- 
ease, the foe we are to grapple and to overcome, 
receive in our hands this weapon — the pure materia 
medica. And before we sally forth to encounter 
the Philistine, we need to "prove" our weapon, 
to test its strength, to feel its sharpness and to 
form an estimate of the feats we may reasonably 
hope to be able to accomplish with it, — to what 
tasks it will probably be equal, and for what others 
we shall need to look elsewhere for an implement. 
Now, as regards the result of the use of a weapon, 
much depends upon its shape, texture and temper. 
But much, likewise, depends on the strength and 
dexterity of him who uses it. The same sword 
that would serve only to trip up an awkward 
wearer may execute wonders of prowess in the 
hand of a master. 

And thus it is with the records that make up 
our materia medica. The facts are the same to 
the eye of every reader. But where one mind 
may see only confusion and a maze of unconnected 



PRELIMINARY OBSERVATIONS. 



63 



words, another may discern order and light and 
the outline of a definite and consecutive chain of 
pathological processes, and, consequently, a clear 
indication for the use of the drugs in the treatment 
of the sick. 

For, while the materia medica, in the books, is 
a simple record of observed facts, in the mind of 
the practitioner it becomes the subject of reflection, 
of comparison and of hypothetical reasoning, which 
will be more or less just and valuable according to 
the measure of the practitioner's natural ability and 
of his intellectual culture. For, as has been already 
said, "the significance of a fact is measured by 
the capacity of the observer." 

It follows, from this, that each practitioner sees, 
in every drug of the materia medica, some proper- 
ties and capabilities different in degree, and perhaps 
even in kind, from those which his neighbors see 
in it, inasmuch as his natural endowments and his 
acquirements differ from theirs. 

The experience of all of us corroborates this 
statement. Where one practitioner perceives in the 
proving of Nux vomica an indication for its use in 
constipation alone, others see equally strong reasons 
for giving it in diarrhoea, in prolapsus uteri, and 
in hernia ; while only a few, perhaps, would find in 
the proving grounds for believing Nux vomica to be, 
as it is, one of our very best remedies in strumous 
ophthalmia. 

Many practitioners infer from the provings that 
Lycopodium is likely to be a good remedy for 



64 PRELIMINARY OBSERVATIONS. 

some forms of chronic constipation and of disease 
of the bladder and kidney. Not so many, per- 
haps, would discern its value, as Dr. Wilson did, 
in acute pneumonia, or, as others have done, in 
that painful form of acute duodenitis which is often 
loosely called bilious colic. Colocynth is univer- 
sally recognized as a remedy for flatulent colic, for 
one form of dysentery, and for a variety of neural- 
gia. But how many practitioners have seen in 
the proving good reason for using Colocynth to 
cure a chronic ovarian tumor? It has cured one. 

It were needless to multiply instances of this 
kind. Those already cited show that, while all 
practitioners read the same proving, they perceive 
each a somewhat peculiar significance in what they 
read. By interchange of ideas on these subject;, 
physicians may be mutually benefited and their 
capacities for usefulness greatly enlarged. It would 
appear, then, that while the text of our materia 
medica should be sedulously kept "pure," as we 
have defined its purity, we may, with profit, inter- 
change our deductions from what we read therein 
and our views of its practical application. 

And there would seem to be not only room, 
but a legitimate demand, for essays, or still better, 
for systematic works on the drugs, studied from 
a therapeutical and clinical point of view, as a sort 
of complement to our materia medica pura, which 
very properly regards the remedies strictly from 
a pathogenetic stand-point. Such works would 
necessarily be of a transient nature and have only 



PRELIMINARY OBSERVATIONS. 65 

an ephemeral value, since they would group symp- 
toms and would necessarily interpret them in 
accordance with the physiological and pathological 
notions of the day. But they might be of none 
the less service to the physician of the generation 
in which they appear, since it is by the light of 
such notions, transitory as they are, that he gropes 
his way among the difficulties and obstacles of his 
professional path. 

Considerations of this kind have emboldened us 
to lay before our colleagues, hitherto always kindly 
indulgent of such efforts, a series of studies and 
reflections upon portions of the materia medica. 
They are avowedly fragmentary, and are devoid 
of all claim to other authority than such as may 
come from their intrinsic reasonableness. 

In the form of these observations, we propose 
to follow, in a general way, the schema contained in 
a paper called "Homoeopathy the Science of Thera- 
peutics" published in another volume, 1 although in 
the remarks on Aconite we prefer to change the 
order there given, making the special analysis 
precede, instead of follow, the general analysis. 

'Homoeopathy the Science of Therapeutics. 



6 



ACONITUM NAPELLUS. 



REGARDING each drug of the materia medica 
as possessed of individual specific properties 
peculiar to itself, and which preclude its being a 
substitute for, or being superseded by, any other 
drug, it is not material with which drug we begin 
our special course. 

Aconitum napellus, known as monkshood, from 
the shape of its flowers, and as wolfsbane, from the 
use made of its poisonous juice to exterminate obnox- 
ious animals, was known to the ancients as an active 
poison, but was first proved by Stoerck in 1761. 
A proving of it was published by Hahnemann in 
the "Materia Medica Pura," vol. 11. A valuable 
essay was published by Dr. Fleming, of Edinburgh, 
in 1844, which did much to cause the drug to be 
used by allopaths. There is no doubt that Dr. 
Fleming derived many of his ideas on the subject 
from the homceopathicians of his vicinity, although 
he does not allude to their use of Aconite. 

It happens that Aconite is frequently indicated 
at the very beginning of some acute diseases and 
that, if properly used in such cases, it will often 



ACONITUM NAPELLUS. 6; 

cut short the career of the disease. From these 
facts has arisen a fashion of giving Aconite almost 
as a routine prescription in the beginning of all 
acute cases indiscriminately; particularly if the cases 
are supposed to be characterized by that Protean 
phantom of the pathologist, inflammation. 

Great mischief often results from this practice ; 
negatively, inasmuch as it causes the loss of valu- 
able time, during which the true specific remedy, 
which should have been given at the very first, 
might have been acting ; and, positively, inasmuch 
as the Aconite often, when inappropriately adminis- 
tered, does real mischief, exhausting the nervous 
power of the patient and adding to a prostration 
which is already, probably, the great source of 
danger. 

From experiments upon animals and men, Drs. 
Pereira and Stille, of the allopathic school, conclude 
that Aconite is a " cerebro-spinant," a "nervous 
sedative." Its first action is to benumb the nerves 
of sensation. This it does when taken internally ; 
producing first, a sensation of warmth in the 
fauces, then, a rough prickling or smarting, and 
then, a want of sensibility and an absence of the 
sense of taste. When applied locally to the exter- 
nal skin, it produces anaesthesia, without, at first, 
impairing the motive power. It does not affect the 
consciousness and intelligence until its action is 
carried to a very considerable extent. (In this 
respect it is in direct opposition to Cocculus.) Pre- 
ceding the anaesthesia, are observed all the sensa- 



68 ACONITUM NAPELLUS. 

tions which characterize incomplete anaesthesia, 
such as tingling and pricking of the fingers and 
toes, numbness, etc. 

A gentle feeling of warmth is diffused through- 
out the body. This soon becomes increased to a 
disagreeable sense of internal heat with distention 
of the brain, lips and face, along with a very pro- 
fuse perspiration over the whole body, itching and 
a miliary eruption. (Pereira, Stille, Wood, Sturm.) 

Dr. Flemine describes, in addition, nausea and 
oppression at the stomach, and a peculiar tingling 
sensation at the roots of the teeth. The pulse and 
respiration, which were at first markedly accelerated, 
become, after a time, retarded and enfeebled. 
When pushed to extremes, the cases of Aconite 
poisoning prove fatal with the usual symptoms of 
narcotico-sedative poisoning. They furnish no dis- 
tinctive characteristic symptoms. 

The proving by Hahnemann was corroborated 
in a remarkable degree by a proving conducted in 
Vienna, in 1847, by the Homoeopathic Society of 
that city, under the guidance of Dr. Gerstel. 
From these combined provings we derive the fol- 
lowing portrait of the action of Aconite, in which 
we shall follow the anatomical order adopted by 
Hahnemann. 

SPECIAL ANALYSIS. 

Sensorium. Aconite produces a well-marked 
vertigo, a sensation as of a swaying to and fro in 
the brain. This is increased by stooping and by 



ACONITUM NAPELLUS. 



69 



motion generally, especially by suddenly rising 
from a recumbent posture. Sometimes vision is 
obscured by it. In connection with these symp- 
toms, a bursting headache, accelerated pulse,- and 
internal heat of the head, with, at the same time, 
perspiration of the head and thorax. The charac- 
ter of the vertigo resembles that of Glonoine and 
Bryonia, and is the opposite of the vertigo produced 
by China, Ferrum and Theridion. 

The mind is distraught, the thoughts confused, 
memory weakened. 

Head. Heaviness and pressure in the forehead, 
as if there were a load there pressing outward, and 
as if all would come out there; pressive pains in the 
temples. Headache, as if the brain were pressed 
outward. Throbbing and internal soreness. Stitch- 
ing and pressing headache, involving the eyes ; also ex- 
tending down into the upper jaw bone, with nausea. 

The headache is characteristic, — pressing from 
within outward, sometimes throbbing. Its location 
is the forehead and temples, involving the eyes 
and upper jaw. It is aggravated by motion, 
stooping and noise, and relieved by repose. Head 
and face are hot, especially internally, and covered 
with hot perspiration. 

Eyes. A sharp, anxious expression. They be- 
come distorted. Sharp, darting pain in the supra- 
orbital region. The pupils are, at first, dilated. 
The globe of the eye and the lids feel very dry. 
Subsequently, there is a feeling of pressure in the 
eye, and pain when the ball revolves in the orbit. 



JO ACONITUM NAPELLUS. 

Severe inflammation and chemosis are recorded. 
Pressure and burning in the eye and over the 
brow. Moderate photophobia. 

Ears. Indefinite pains and pressure. 

Face. Tinsrling in the cheeks. Sweat covers 
the cheeks. The face is red and hot, cheeks glow. 
A sensation as if the face were growing large. 

Nose. Nose-bleeding. 

Mouth. The lips burn and feel swollen. 
Mouth dry with thirst. 

Teeth. Sensitive to cool air. 

Tongue. Burning, tingling and pricking. Feels 
as if it were swollen. 

Throat. Rough and scraped sensation. 

Gastric Symptoms. Bitter, flat taste. Loss of 
appetite, salivation, great thirst, discomfort after 
food, nausea and vomiting. Burning in stomach 
and oesophagus. 

Stomach. Pressure in the stomach and both 
hypochondria as if a stone lay there (resembles 
Bryonia, Arnica) extending through to the back. 

Heaviness in stomach and hypochondria. After 
repeated vomitings there still remains a sensation 
as if a cold stone lay in the stomach. (Compare 
Colchicum.) 

Burning in the stomach and umbilical region 
extending to the epigastrium with throbbing, at 
length a shivering followed by heat. 

Abdomen. Pinching pain in various parts of 
the abdomen. Very sensitive to touch and pressure. 
Distended as in dropsy. 



ACONITUM NAPELLUS. J i 

Stool. Fluid, rather watery. Sometimes green- 
ish, with some pain and flatulence. Generally 
fcecal. Irritation of the haemorrhoidal vessels. 

Anus. Sensation as of a discharge of warm 
fluid from the anus. 

Urine. High colored, strong in odor and 
scanty, without sediment. It is passed frequently. 
Upon the sexual organs no definite effect is noticed. 

Respiratory organs. Sense of smell unnaturally 
acute. Nasal membrane dry and irritable. Sneez- 
ing frequent and violent, though often restrained 
because of the pain which it produces in the walls 
of the abdomen or of the stitch in the left side 
of the thorax, which it often provokes. 

Larynx and Trachea. Larynx very painful. 
Sensitive to inhaled air, as if it were deprived of 
its outer covering. This is an intense degree of 
the sensation of rawness, roughness, etc., in the 
larynx, of which every prover complains. 

Sensation as if the larynx were compressed 
from all sides. Sensation of dryness and rough- 
ness in the larynx and all along the trachea. This 
sensation often gives rise to a little hacking cough. 

Irritation (provoking a cough) in the larynx, 
on coming from the open air into a warm room. 
(Ranunculus bulbosus, the same. Rumex, Squilla, 
Ipecacuanha and Bryonia, have cough provoked by 
change from cold to warm air.) 

Cough. Dry, hacking, from rawness in larynx 
and trachea. Or a forcible cough, producing a 
taste like that of blood. 



J2 ACONITUM NAPELLUS. 

Cough always dry, except when attended by 
clear bloody expectoration. 

Cough accompanied by excoriated sore pains in 
the thorax. 

Cough relieved when lying on the back, worse 
when lying on the sides. 

Expectoration bloody, or consisting of clear 
blood. 

Thorax. Much dyspncea. Frequent deep sigh- 
ing respiration. One prover, Zlatarovich, says : 

" Frequent deep inspiration, not sighing, but 
like a desire to accelerate the course of the blood 
through the lungs." 

Heaviness and fullness upon the chest, as though 
one could not dilate the thorax, compelling deep 
inspirations, conjoined with, restlessness, anxiety and 
palpitation. Audible (subjectively) crepitation. Ac- 
celerated breathing. 

Besides the heaviness, there are ill-defined 
stitches in the intercostal spaces, generally low on 
the right side, aggravated by deep inspiration. 

Heat and burning in the lungs. 

Heart. Movements irregular and inharmonious. 
Palpitation, which is worse when walking. Violent 
palpitation, with great anxiety, during repose as 
well as in motion. Anguish in the region of the 
heart, with rapid and powerful action of that organ. 

Oppression, especially in the region of the heart. 
A pressing-in pain in the region of the heart. 

The following remarkable symptom is reported 
by Zlatarovich, a keen and daring prover: Lanci- 



ACONITUM NAPELLUS. 73 

nating stitches in the region of the heart, feeling 
as if they were in the costal pleura, and which 
prevent the erect posture and deep inspiration, 
with disposition to cough ; relieved by friction and 
by occasional deep inspiration ; but the part remains 
sore. 

Back. Pressive, drawing, tearing and numb 
sensations in various parts of the back. Sensitive- 
ness in the region of the kidneys. Particularly a 
weariness and soreness in the lumbar and sacral 
region. 

Upper Extremities. The same creeping, ting- 
ling, paralytic sensations in these parts as in the 
skin generally. Drawing, tearing pains in the 
joints of the hands and fingers. 

Lower Extremities. Great lassitude of the legs, 
and weariness and heaviness of the feet. They 
refuse to perform their function. Drawing pains in 
the hip-joint on motion. Drawing and tearing 
in the tendinous expansion of the legs and feet. 
Drawing and pain in the tendo Achillis. 

Sleep. Great sleepiness, as if from exhaustion, 
during the day. Nights are very restless. Patients 
sleep lightly ; are too wide awake to sleep ; rest- 
less and full of dreams. 

Restless, alternating cold and heat, thirst and 
anguish. 

Dreams terrifying and very vivid. 

Skin. Itching, tingling, prickling, and paralytic, 
and all degrees of commencing and incomplete 
anaesthesia. 



74 ACONITUM NAPELLUS. 

Reddish papules, filled with acrid moisture. 
Broad, red itching papules on the whole body, 
spots like flea-bites on the hands, face, etc. 

General Condition. Whole body sensitive to 
touch. 

Sensibility as after a long fit of sickness. 

Paralytic sensation and lassitude in the whole 
body, especially in the arms and feet, with trem- 
bling of the whole body, and especially of the 
extremities, — one can hardly walk, — with very pale 
face, dilated pupils, faintness, palpitation, cold 
sweat on the back, and a bursting asunder head- 
ache in the temples. Soon after this comes burn- 
ing heat in the face, with sensation of distention, 
redness of the face and sleepiness. 

Joints. Pains in all the joints. Weakness of 
the joints, especially of the knees and feet. Weak- 
ness and laxity of the ligaments of all the joints. 

Fever. Chilliness, especially over the back and 
abdomen. Fugitive chills from the middle of the 
spine down the loins on each side. 

Chilliness and formication between the shoulders 
and down the back. Shivering. 

These symptoms at first alternate with heat, 
and are, finally, followed, as the Austrian provings 
show, by general and constant heat; dry heat of 
the whole body; burning heat; heat with moderate 
sweat. 

Heat, with contracted, full, strong pulse, about 
100 per minute in the adult. 

Copious sweat, especially at night. Special and 



ACONITUM NAPELLUS. 



75 



general senses unnaturally acute. Noise, light, 
odor and touch are unpleasant. 

Disposition. Very anxious, restless, full of 
forebodings, either ill-defined forebodings, or, some- 
times, a definite anticipation or prediction of the 
day of death. 

If we now review the symptoms of Aconite, as 
they have been detailed, for the purpose of making 
a general analysis of the action of that drug upon 
the organism, we find, 

1. The action on the vital power is of such a 
nature that while the nerves of sensation are more 
or less benumbed (by large doses), the voluntary 
and involuntary muscles and the power of locomo- 
tion are but little affected. The action on the 
sensorium and on the special senses may, perhaps, 
be accounted for by that which is the most marked 
effect of Aconite, viz., the exalted activity which it 
produces in the arterial circulation. 

The brain is congested ; so are the lungs and 
the kidneys (as, indeed, the autopsies plainly 
show). The susceptibility of the special senses is 
greatly exalted. 

2. Action on the Organic Substance. Of very 
few drugs, so powerfully poisonous as Aconite is, 
even in moderate doses, can it be said, as of 
Aconite, that they produce hardly any appreciable 
effect upon the organic substance, — hardly any 
change in the tissues or fluids of the body. The 
records of fatal cases of poisoning, as well as our 
provings, bear witness to this fact. 



76 ACONITUM NAPELLUS. 

The complexion is affected only in so far as 
the capillary blood-vessels are contracted, producing 
paleness, and then congested, with redness and 
heat. 

The evacuations can hardly be called abnormal, 
the urine being merely high-colored, inasmuch as 
it is concentrated. It is a peculiarity of Aconite 
that urine secreted under its influence has no sedi- 
ment. 

The cutaneous eruption furnishes the only mod- 
ification to the above statement. It is of such a 
character as led Hahnemann to recommend Aconite 
in some cases of measles and miliary rash. There 
is no resemblance in the symptoms of Aconite to 
the features of any dyscrasia. 

3. Sphere of Action. The head, the respiratory 
organs, the heart and the joints', seem to be the 
parts most markedly the seat of the local action 
of Aconite. In all of these, except, perhaps, the 
joints, the symptoms point rather to arterial excite- 
ment than to definite organic change, involving 
alteration of existing tissues or formation or deposit 
of new substances. 

4. Sensations. These are mostly drawing 
pains, — or the various grades of anaesthesia, — from 
sticking, prickling, tingling, etc., down to absolute 
default of sensation. 

5. Periodicity. None at all. 

6. Peculiarities. The symptoms of Aconite 
are generally aggravated by warmth and motion, 
and also at night. 



ACONITUM NAPELLUS. 77 

There is one group of symptoms so character- 
istic of Aconite that Hahnemann said, "Aconite 
should not be given in any case which does not 
present a similar group of symptoms." These are 
the symptoms of the mind and disposition, viz. : 
Restlessness, anxiety and uneasiness of mind and 
body, causing tossing and sighing and frequent 
change of posture ; forebodings, anticipations of 
evil, anguish of mind, dread of death, and even 
distinct anticipations of its occurrence. 

Turning now to consider the kind of cases in 
which Aconite is most likely to be indicated by the 
similarity of its symptoms, we cannot do better 
than carefully ponder Hahnemann's most excellent 
cautions, contained in the introduction to the prov- 
ing of Aconite. " In order to banish from our 
conscientious mode of treatment all of that quackery 
which is only too glad, in selecting its remedy, to 
be guided by the name of the disease, we must 
take care that whenever we give Aconite the chief 
symptoms of the malady, that is, of the acute dis- 
ease, shall be such as are to be found in the 
strongest similarity among those of Aconite ! " 

This is the whole secret of a successful pre- 
scription of any drug under any circumstances, viz. : 
that whatever name we may choose to give to the 
patient's malady we shall select for its cure that 
drug which presents symptoms most similar, not to 
those which we regard as pathognomonic of the 
disease so named, but to those of that very patient, 
at the time of the prescription. "Then," as Hah- 



78 ACONITUM NAPELLUS. 

nemann truly says, " then is the result most won- 
derful." 

Hahnemann speaks of Aconite as likely to be 
of service "in those cases in which medicine has 
hitherto employed the most dangerous methods, — 
for example, copious blood-letting, the entire anti- 
phlogistic apparatus, — and, too often, in vain and 
with the saddest results. I mean the so-called 
inflammatory fever in which the smallest dose of 
Aconite makes the entire antipathic methods of 
treatment altogether superfluous, and helps quickly 
and without sequelae. In measles and miliary fever 
and in inflammatory pleuritic fevers, its power to 
help approaches the marvelous, when, the patient 
being kept somewhat cool, Aconite is given alone, 
all other medicinal substances being carefully 
avoided, even including vegetable acids." He then 
cautions us to avoid prescribing Aconite for a 
patient simply because we have given to his malady 
one of the above names, and enjoins us to be sure 
that the patient's symptoms closely correspond with 
those of Aconite. 

"Exactly in those cases," he proceeds, "in which 
allopathy is most accustomed to regard herself as the 
only possible savior, in severe, acute, inflammatory 
fevers, in which she resorts to copious and frequent 
bleedings, and thereby imagines she far surpasses 
all homoeopathic treatment in the help she affords 
— exactly here, is she most in the wrong. Pre- 
cisely in this is the infinite superiority of homoe- 
opathy displayed; that she has no need to spill a 



ACONITUM NAPELLUS. 



79 



drop of blood, that precious vital fluid (which the 
allopaths so ruthlessly set streaming), in order to 
convert this dangerous fever into health again in 
just as many hours as the allopathist's life-exhaust- 
ing treatment often requires months for a complete 
restoration ; if indeed death shall not have rendered 
this impossible, or if it have not been supplanted 
by artificially produced chronic sequelae." 

''Sometimes," Hahnemann observes, "after Aco- 
nite has acted for several hours, a change in the 
symptoms may call for some other remedy ; and," 
he adds, " it is extremely seldom that, after this, a 
second dose of Aconite is called for." It is mani- 
fest that the too frequent practice of giving in 
alternation repeated doses of Aconite and Bella- 
donna, or Aconite and Bryonia, or Aconite and 
some other remedy, did not originate, and would 
not have found favor with Hahnemann. 

Hahnemann continues : " In as short a time as 
four hours after the first dose of Aconite, thus 
carefully administered in the above-named diseases, 
all danger to life will have passed and the excited 
circulation will then, hour by hour, gradually return 
to its wonted course. 

"So, likewise, Aconite, in the above-named 
small dose, is the first and chief remedy in the 
inflammation of the trachea (croup); in several 
kinds of inflammation of the throat and fauces; as 
well as in local acute inflammations of all other 
parts, especially where, in .conjunction with thirst 
and a rapid pulse there are present an anxious 



8o 



ACONITUM NAPELLUS. 



impatience, a restlessness not to be quieted, distress 
and an agonized tossing about. 

"Aconite produces all the morbid symptoms, 
the like of which are wont to appear in persons 
who have had a fright, combined with vexation; 
and for these symptoms it is the best remedy. 

"Always, in choosing Aconite, as the homoeo- 
pathic remedy, especial regard must be paid to the 
symptoms of the disposition and mind, for these, 
above all, must be similar. 

" Hence, Aconite is indispensable to women 
after fright and vexation, during menstruation, 
which, without this soothing remedy, is often 
instantaneously suppressed by such moral shocks." 

If we add to these practical directions of 
Hahnemann, the conclusions to which our analysis 
of the sphere of action of Aconite has led us, we 
shall begin to comprehend a large variety, at least, 
of the cases which call for Aconite. 

As we have seen, Aconite, when given in mod- 
erate doses, excites the circulation, increases the 
heat of the surface and produces perspiration ; it 
affects the innervation, producing extreme sensitive- 
ness of the surface of the body to contact and the 
correlative sensation of tingling, etc. ; in short, an 
incomplete anaesthesia. But it does not alter (in 
kind) the function of any organ, nor does it set 
up any new action in any organ or tissue. 

Aconite produces, so far as we know, almost 
no localized diseased condition. 

Even when given in large and fatal doses, it 



ACONITUM NAPELLUS. 



81 



acts as a depressant, paralyzing the cerebro-spinal 
nervous system ; but it produces death by this 
paralysis and without previously localizing its action 
in any organ or system. It gives evidence of no 
dyscrasia. Its action bears no resemblance to that 
of the poison which produces any of the miasmatic 
diseases — such as the exanthemata, or typhus or 
intermittent, remittent or continued fevers. Neither 
does its action, from beginning to end of a fatal 
case of poisoning, resemble the well-defined course 
of any local, acute inflammation — as of the brain, 
heart, lungs, pleura, etc. 

For these reasons, Aconite can never come into 
requisition (save possibly (?) as a rare and tempo- 
rary intermittent in some complication) for any of 
the miasmatic fevers or dyscratic diseases ; because, 
in these the dyscrasia precedes and gives its 
features to the acute manifestations of the disease 
(and, therefore, the symptoms cannot find their 
analogue in those of Aconite). 

Moreover, Aconite can never be the single 
remedy by the influence of which a patient may 
be safely carried through a complete course of 
pure, acute inflammation of any organ or system; 
because, in the action of Aconite, that localization 
is lacking which is the essential feature of these 
diseases. Yet in all of these pure inflammations, 
there is a period in which Aconite may be indi- 
cated and may do an heroic work. For every one 
of these inflammations which eventually become 
localized has a first stage which consists of arterial 

7 



82 



ACONITUM NAPELLUS. 



excitement; and which is prior to that stage that 
is characterized by change of function and of tissue 
and by local deposit. This stage is that in which 
Aconite plays so important a part and in which, 
if promptly and judiciously employed, it may arrest 
and cut short the entire disease. 

Thus it may be employed in meningitis, 
ophthalmia, tonsillitis, croup, bronchial catarrh, 
pneumonia, pulmonary congestion and haemoptysis, 
pleuritis, pericarditis and endocarditis (and as a pallia- 
tive in hypertrophy), gastritis, peritonitis, acute rheu- 
matism, neuralgia supra-orbitalis ; but only when the 
moral symptoms named by Hahnemann are present. 

It is to such a use of Aconite in acute inflam- 
mations that Hahnemann undoubtedly refers when 
he speaks of its ability to restore to health in a 
few hours, saying: "In as short a time as a few 
hours, after the first dose of Aconite, thus carefully 
administered * * all clanger to life will have 
passed and the excited circulation will then, hour 
by hour, gradually return to its wonted course." 
So rapid a change as this would be very possible 
and easily conceivable in the first stage of acute 
pneumonia before hepatization has taken place ; 
whereas, after hepatization has become established, 
it would not be conceivable and we have no reason 
to suppose it ever takes place. Hence the pro- 
priety of Hahnemann's caution, in the following 
words : " Sometimes after the Aconite has acted for 
several hours, a change in the symptoms may call 
for some other drug; and it is extremely seldom 



ACONITUM NAPELLUS. 



83 



that, after this, a second dose of Aconite is called 
for." Why? Because, probably, the inflammation 
has passed from the stage of arterial excitement to 
that of organic localization, and Aconite no longer 
corresponds. And, probably, that very "change in 
the symptoms" which called "for some other 
drug," was a sign that localization had taken place. 

This view is in entire harmony with Hah- 
nemann's urgent admonition to heed what he 
regarded as the great characteristic indication of 
Aconite : " the anguish of mind and body, the rest- 
lessness, the disquiet not to be allayed." This state 
of mind and body accords precisely with the gene- 
ral phenomena of that arterial excitement which 
attends the invasion of an acute inflammation, 
while the localization of the inflammation and the 
occurrence of exudation are marked by a subsidence 
of this general anguish; symptoms of local organic 
embarrassment being substituted for it ; and the 
general constitutional symptoms being rather those 
of exhaustion and a depressed condition. Who- 
ever has closely watched a number of cases of 
pneumonia through the first and second stages 
will, I think, corroborate these views. 

Here, then, we have again an example of what 
the student of materia medica so often meets, — 
the entire coincidence of the teachings of a sound 
pathology with the results of an intelligent and 
discriminating application of the law of the selec- 
tion of the drug by the correspondence of charac- 
teristic symptoms. 



84 ACONITUM NAPELLUS. 

Though it is always hazardous to undertake the 
illustration of a scientific point by a rhetorical 
simile, we may venture to liken the action of Aco- 
nite and cognate remedies to the onset and effects 
of a tempest. Whoever is familiar with the gen- 
eral character of North America from the Alle- 
ghanies to the Atlantic, must have had opportunity 
to overlook some fertile valley in the luxuriance 
of its midsummer vegetation. As he enjoys the 
prospect, the breeze subsides, and the sunlight 
becomes obscured. The cattle cease to graze ; they 
move uneasily through the field and snuff the air 
as if in dread. Soon the incongruous swayings of 
the foliage in different parts of the valley make it 
evident that the air is agitated by varying eddies 
and currents. To the same cause are due the 
variations in the sounds of the murmur of the 
brook and the hum of insects and the chitter of 
birds, that are brought to the ear at successive 
moments. Clouds of dust rise from portions of 
the winding road and are borne whirling along 
and upward. The cattle become more and more 
uneasy ; they rush wildly to and fro through the 
meadows. A sound as of rushing waters comes 
up the valley, with a blast of cool air having an 
odor of freshly cut herbage, or faintly ammoniacal; 
clouds of dust envelop the spectator ; the tempest 
breaks upon him and for a time he realizes noth- 
ing but wild confusion, and the crash and roaring 
of the elements in unrestrained collision. 

After a short time the winds abate ; the atmos- 



ACONITUM NAPELLUS. 



85 



phere becomes clear and quiet prevails again. All 
things have resumed their normal state. Nature, 
animate and inanimate, has come to her former 
condition of repose. The violence of the tempest 
has swept past, — to spend itself in permanent 
effects elsewhere. 

This represents, well enough, the action of 
Aconite, which raises an arterial and nervous storm, 
and, though in fatal cases its fury may be great 
enough to induce chaos, that is, death, yet it 
does not localize itself in organic changes. Or, if 
the tempest be considered as representing disease, 
then Aconite is a happy influence (we know of 
none such in inanimate nature) which turns aside 
its force and sends it to expend its energies in 
material changes elsewhere. 

But, the tempest does not always pass thus 
lightly over the valley. It too often happens, that 
when the calm that follows its outbreak permits 
the spectator again to survey the region, he looks 
upon a scene wholly changed. Trees have been 
prostrated, perhaps, and buildings overturned. The 
mill has been carried away, the dam has failed to 
resist the sudden increase of the stream ; where 
was once a broad expanse of tranquil water is now 
an oozing waste, threaded by a narrow creek. 
The cattle are scattered and the crops destroyed. 
Havoc has been made and desolation reigns. The 
processes of nature still go on, but in every condi- 
tion how changed ! 

This represents, in some sort, the action of 



86 



ACONITUM NAPELLUS. 



drugs which, like Aconite, produce a storm of 
general vascular and nervous excitement, but which, 
unlike Aconite, produce, after this storm, as a sort 
of sequel of it, a definite localization of pathogenetic 
action, viz., changes of function and tissues. 

Such a remedy is Bryonia, in its action on the 
lungs and pleura, and Belladonna, in its action on 
the brain and lungs ; such, indeed, are most of our 
remedies. For there are few storms which do not 
make more or less of local havoc. 

With a few disconnected remarks, we may close 
these desultory observations. 

It is clear that Aconite may be given in acute 
inflammation of every organ of the body, but only 
in a certain stage of a certain form of inflammation. 
How shall we know when this stage and form are 
before us-? When, in addition to whatever signs 
there may be which designate the organ which is 
affected, the symptoms which have been called 
characteristic of Aconite are present ; the heat of 
surface, or external cold and internal heat, thirst, 
quick, excited but not hard pulse, copious sweat 
with burning heat; and, above all, anguish and 
restlessness of mind and body, tossing which will 
not be quieted, foreboding and anticipation of death. 

So, then, after all this talk, involving the terms and 
speculations of pathology, the selection of the remedy 
comes down again to a comparison of symptoms. 

Yes! for the sagacity of the master led him to 
see clearly that the symptoms of the patient are 
the only facts of which we have absolute knowl- 



ACONITUM NAPELLUS. 



87 



edge as concerns the patient ; and the symptoms 
of the drug are the only facts that we absolutely 
know respecting it, and the relation in which they 
must be placed to neutralize each other, if it be 
found, must be such as to satisfy every sound 
hypothesis constructed on these facts. It must, 
consequently, harmonize with sound pathology. 
And many times this volume of talk will have 
been well bestowed if it shall convince any thought- 
ful mind that, first and most important, stands the 
correspondence of symptoms according to their 
rank, and that to this same result all sound hypoth- 
eses must lead. 

Aconite is never to be given "first to subdue 
the fever," and then some other remedy to "meet 
the case ;" never to be alternated with other drugs 
for the purpose, as is often alleged, of " controlling 
fever." If the fever be such as to require Aconite, 
no other drug is needed. If other drugs seem 
indicated, one should be sought which meets the 
fever as well ; for many drugs besides Aconite 
produce fever, each after his kind. 

Aconite may be called for, if the symptoms 
correspond, in the first stage of every acute 
inflammation, but remove from the mind the idea 
that it cures all inflammations ; e. g., in the sec- 
ond stage of pneumonia it is good for nothing. 

It is a remedy of unspeakable value in a vast 
many cases of acute haemoptysis, which present the 
general symptoms as above detailed, characteristic 
of Aconite, and yet the pathological origin of 



88 



ACONITUM NAPELLUS. 



which, and their ultimate nature, if not controlled, 
are involved in obscurity. The blood is florid. 
(Spitting of florid blood, without the restless an- 
guish of Aconite, calls for Millefolium.) 

Aconite should never be given to "save time" 
while the physician goes home to study up the 
case. This is slovenly practice; it were better to 
give nothing, because Aconite, if given in a case 
which does not call for it, may do mischief; as, 
for example, in the commencement of typhoid 
fever, in which it will unfavorably influence the 
entire course of the disease, unless symptoms call 
for it, which they rarely if ever can do. 

Notwithstanding this fact, so wide-spread has 
the notion become that Aconite is the remedy 
for fever, that the allopaths have adopted and are 
now using it as the stock remedy for typhoid fever 
in Bellevue Hospital (1864). The death rate docs 
not lessen. Prescribing on a single symptom (it 
reduces the pulse in large doses) they give it in 
typhoid, overlooking the great pathological fact of the 
dyscrasia, to which Aconite has no relation whatever. 
Had they adopted Arsenic for typhoid, there would 
have been good pathological defense for them. 

There are writers on the homoeopathic materia 
medica who create a theory of the action of 
Aconite, and make it the great antiphlogistic. 
Hence they are compelled by logical consistency 
to recommend Aconite in all diseases, a flagrant 
illustration of the folly of prescribing on a patho- 
logical theory. 



BRYONIA ALBA. 



THE tincture of the root of Bryonia alba, or 
dilutions made from it, were used by Hahne- 
mann in his provings. The root of this vine, 
which grows in hedge-rows and along fences in 
England and on the continent of Europe, furnishes 
us the tincture from which our preparations are 
made. 

Pereira calls Bryonia a violent emetic and pur- 
gative. Trousseau and Pidoux speak of it as an 
active purgative, to be used like Colocynth and 
Elaterium. But Hermand de Montgomery declared 
that he had frequently cured vomiting, colic, diar- 
rhoea and dysentery, with Bryonia, — an illustration, 
from allopathic sources, of the homoeopathic curative 
action of this drug. 

In the majority of modern works on materia 
medica, of the allopathic school, Bryonia is not 
mentioned. Yet it has for centuries been recog- 
nized, among the people of Europe, as a specific 
for certain ailments, and eminent physicians of 
earlier ages have recorded many cures by it. 
Cataplasms of the root were successfully used to 



gO BRYONIA ALBA. 

scatter inflammatory swellings of the joints. This 
was a homoeopathic prescription in so far as the 
selection of the drug was concerned. The ancients 
cured dropsy with it, and especially hydrothorax 
(and we use it for pleurisy with fluid exudation). 
Sydenham used Bryonia as a remedy for intermit- 
tent fever. Teste says the French peasants of 
Lorraine use the root as a specific remedy for 
hernia. I learned from observation that among the 
peasants residing in the Maremma, on the shores 
of the Mediterranean, north of the Pontine marshes, 
Bryonia is commonly (and successfully) used as a 
remedy for the peculiar type of intermittent and 
remittent fever which is endemic there. We shall 
see how these instances confirm the law of Similia 
similibus curantur. 

Our entire knowledge of the action of Bryonia 
on the healthy subject is derived from the proving 
by Hahnemann and his pupils, 1 and from the Aus- 
trian provings, arranged by Professor Zlatarovich. 2 
From these sources we construct the following 
resume in which, as before, we follow the anatomi- 
cal order: 

Sensorium. The action of Bryonia is well 
defined and constant. Every prover describes, in 
language more or less emphatic, a " confusion of 
the head," a " distracted state of the sensorium." 
When we consider this symptom in conjunction 
with the peculiar febrile symptoms, the lassitude, 

1 " Materia Medica Pura," vol. ii. Zeitschrift," vol. iii., 1857. '"CEs- 

2 "CEstliche Homoeopathische terreichische," 1847, vol. iii. 



ERYONIA ALBA, 



91 



etc., we shall perceive its significance. Great heavi- 
ness of the whole head. Weight upon the vertex. 
Vertigo, when fasting, when standing, and especially 
on first rising from a seat, compelling to sit ; often 
conjoined with headache in the occiput, aggravated 
by motion. 

Headache. Dull, pressing headache in the fore- 
head and temples ; drawing and tensive headache 
in the temporal region ; drawing and tearing pain 
from the temple down to the malar bone and to 
the lower jaw (this symptom promises aid from 
Bryonia in prosopalgia). Sticking, jerking, throb- 
bing headache from the forehead backward to the 
occiput. (This symptom is characteristic, being 
paralleled in no other drug. Spigelia has pain 
darting from behind forward through the left eye- 
ball. Silicea has pain coining up from the nape of 
the neck, through the occiput and over the vertex, 
and so down upon the forehead. Carbo vegetabilis 
has dull, heavy pain extending through the base of 
the brain, from the occiput to the supra-orbital 
region.) 

The majority of the head-symptoms of Bryonia 
refer to the occiput, and we shall find it more fre- 
quently called for in headache involving the occiput. 
In this respect it may be compared with Petroleum. 

The sensorium is blunted. 

All the symptoms of the head are aggravated 
by motion and exertion. 

The pathologico-anatomical results of Bryonia 
poisoning are : " Redness of the diploe, injection of 



9 2 



BRYONIA ALBA. 



the inner surface of the cranium. Congestion of 
the membranes. A section of the cerebral sub- 
stances is dotted here and there with blood." 

Zlatarovich says : " The head-symptoms point 
to congestion and inflammation of the brain ; " but, 
I think, the character of the fever and of the 
affection of the sensorium is such as to show that 
it is not likely to be a remedy in pure idiopathic 
encephalitis. If a remedy in encephalitis at all, it 
must be in those cases in which meningitis has 
supervened, by metastasis or otherwise, upon some 
previously existing miasmatic or other disease, e. g., 
one of the exanthemata. The pains and perverted 
function of the two upper branches of the fifth 
pair of nerves call to mind prosopalgia. 

The affections of the head and sensorium are 
worse in the morning ; not immediately on awaking 
(as with Lachesis), but after waking and moving 
the eyes and head (see stool — diarrhoea). 

Face. Red, hot and puffed. Red spots on the 
face and neck. The face is swollen ; sometimes 
so much so as to close the eye. The pains are 
those that have been described as extending 
.between the temple and the malar bone, and are 
of a tearing, drawing character. 

Eyes. Lids swollen and puffed. A sensation 
of pressure from within outward in the globe of 
the eye, a kind of distention. The conjunctiva 
seems to be moderately inflamed, judging from 
these symptoms : sensation as if there were sand 
in the eyes ; increased secretion of tears ; discharge 



BRYONIA ALBA. 93 

of muco-pus from the eye, obstructing vision ; itch- 
ing and burning of the margin of the lids. The 
right eye is most affected. 

Contrary to the general rule with Bryonia, the 
eye symptoms are aggravated by warmth. The 
special sense of vision is not affected in Hahne- 
mann's proving, but Zlatarovich mentions a play of 
colors. 

Ears. Sensation of obstruction in the external 
meatus and noises in the ears are the chief symp- 
toms. Discharge of blood from the ear is men- 
tioned ; this may possibly be accounted for as an 
instance of vicarious menstruation. 

Nose. ' Often swollen at the extremity, with a 
sharp pain and sensitiveness to the touch. Frequent 
and repeated epistaxis, — a symptom recorded by 
many provers. It occurs in the morning, some- 
times awaking the prover from sleep. The blood 
is florid. Nose-bleeding after the sudden suspension 
of menses has been observed under the action of 
Bryonia. It is probably this symptom which has 
induced the use of Bryonia in vicarious menstrua- 
tion. 

Mouth. The lips are swollen, with a biting, 
burning eruption. Aphthous patches appear on the 
lining membrane of the mouth and fauces. Dr. 
Huber, of Lenz, one of the Austrian provers, 
states that his proving of Bryonia cured him of a 
constitutional tendency to aphthous formations in 
the throat. The tongue is dry. 

The teeth feel long and loose ; drawing or 



94 



BRYONIA ALBA. 



jumping toothache when eating or just after eating, 
or in the evening in bed ; aggravated by warmth, 
contrary to the general rule with Bryonia. Teeth 
and gums are sore. 

Throat. Sticking pain on swallowing, on feel- 
ing of the throat and on bending the neck. 
Sensation of pressure or fullness. Great dryness in 
the throat. 

Digestive Organs. Taste unpleasant, flat, even 
with good appetite ; sometimes bitter, sometimes 
putrid, with offensive breath ; appetite generally 
diminished or destroyed, with aversion to food. 
One prover (Fr. H.) records an excessive desire 
for food, which, however, ceased as soon as the 
prover began to eat. 

Thirst increased. 

After eating, eructations, sometimes tasting of 
the food but generally bitter or sour, with an 
accumulation of sour water, sometimes tasteless, in 
the mouth. 

Hiccough is a frequent symptom. 

Nausea after a meal, although the food tasted 
well and was eaten with relish. 

Nausea and vomiting, morning and evening, 
chiefly of water and mucus. Also, vomiting of food 
and of a fluid consisting of mucus and bile, and 
very bitter. 

Food oppresses the stomach, is felt like a load 
at the epigastrium, and is often regurgitated. 

Stomach and Abdomen. Pressure in the epigas- 
trium, worse after eating and when walking. This 



BRYONIA ALBA. gc 

pain sometimes extends down to the umbilical 
region; sometimes even to the bladder and peri- 
naeum. 

After eating, there is often a constricting pain 
in the stomach, then a cutting in the epigastrium 
and then vomiting of food. The pains are worse 
during motion as is the general rule with Bryonia 
pains. 

Sensation of distention, and sometimes actual 
swelling in the umbilical region. 

Pains, sticking and shooting in both sides of 
the abdomen, aggravated by motion and sometimes 
changing into stitches from the abdomen into the 
stomach. The stitches are most frequent in the 
region of the spleen. 

In the hepatic region, on the contrary, we find 
a tensive, burning pain ; with a stitch which occurs 
only when the region is pressed upon, or when 
the prover coughs or takes a deep inspiration. 

Flatulence moderate. Its movements occasion- 
ally produce pain. 

Stool. It is a peculiarity of Bryonia that, in 
moderate doses, it produces, in the healthy prover, 
retention of stool ; the stool is infrequent, large in 
form, solid and evacuated with difficulty and 
attended by prolapsus of the rectum and burning 
sensation. Besides this characteristic action, Bryo- 
nia produces also, as an alternate action, a kind of 
diarrhoea preceded by colic, occurring especially at 
night (or early morning as soon as the patient 
rises and begins to walk about), and coming on so 



g6 BRYONIA ALBA. 

suddenly that the prover can hardly prevent an 
involuntary evacuation. 1 

Zlatarovich calls especial attention to the tender- 
ness of the abdominal walls generally ; to the 
burning pains along the anterior connection of the 
diaphragm with the ribs ; to the sensitiveness of 
the hepatic region to touch and on deep inspiration; 
also to the fact that Bryonia diminishes the intes- 
tinal excretions, weakens the peristaltic action of 
the bowels, and retards the stool. It produces 
diarrhoea, he thinks, only when taken in very large 
doses. 

Urine. The urine is high-colored, concen- 
trated ; passed frequently, sometimes with pain. 
Occasionally, during exertion, it is passed invol- 
untarily. 

Menstruation. Bryonia uniformly hastens the 
coming on of the menses, and increases the flow. It 
may, therefore, as experience has shown, be a val- 
uable remedy in too frequent and too copious 
menstruation. 

Respiratory Organs. The action of Bryonia on 
this region of the body is well marked, and has 
enabled us to make many brilliant cures. 

Nasal Membrane. Fluent coryza, beginning 
with violent and frequent sneezing, accompanied by 
stitching headache, when the prover stoops, and 
by hoarseness and an altered tone of voice. 



'For a comparative notice of Dr. Lippe's lecture, "American 
the diarrhoea of Bryonia, Sulphur, Homoeopathic Review," vol. v., 
Thuja, and Podophyllum, see p. 441. 



BRYONIA ALBA. 



97 



Cough. Generally dry ; it seems to come from 
the region of the stomach, and is preceded by a 
crawling and tickling sensation in the epigastrium. 
This is the general characteristic ; sometimes there 
is a crawling sensation in the throat also, inducing 
a cough, followed by mucous sputa. 

Hacking cough, as if caused by something 
(mucus?) at a definite spot in the trachea; after 
coughing for some time this spot becomes very 
sensitive, and it is worse from talking and smoking. 

Cough induced by coming from the open air 
into a warm room ; from a sensation as of a vapor 
in the trachea, which prevents the prover getting 
air enough. 

Concomitants. The cough is accompanied by 
stitching pains in the brain ; by rawness in the 
larynx ; by stitches in the intercostal spaces and in 
the sternum ; by soreness in the epigastrium ; by 
gagging, without nausea; by vomiting of food when 
coughing. 

It is very characteristic of the Bryonia cough 
that, while coughing, the patient presses with his 
hand upon the sternum, as though he needed to 
support the chest during the violent exertion. Also, 
that the parts which are the seat of subjective pain 
become subsequently sensitive to external pressure; 
e. g., the sternum. (So also the joints.) 

The expectoration, which is infrequent and 
scanty, is tough and sometimes bloody. 

Respiration is impeded, as though by a press- 
ure on the epigastrium, and is accelerated, as 
8 



98 



BRYONIA ALBA. 



though by a feeling of heat in the epigastrium and 
chest. The prover feels a desire to take a deep 
inspiration, but when he attempts to do. so he 
experiences a pain which does not allow him to 
expand the chest. Thoracic respiration is often 
almost impossible, by reason of the stitching pains 
in the sides of the thorax. These symptoms might 
call our attention to Bryonia in pleurisy, pneumonia 
and asthma. Ranunculus bulbosus has similar 
symptoms which, equally with the Bryonia pains, 
impede thoracic respiration ; but the stitches are 
not so sharp and knife-like as those of Bryonia. 

Thorax. Pressing pains, sometimes just above 
the epigastrium, sometimes over the whole chest, 
or on the sternum, impeding respiration. Stitching, 
lancinating pains are, however, more frequent. 
They occur on inspiration, or on turning around in 
bed ; they are situated sometimes in the sides of 
the thorax, and sometimes they extend through the 
thorax from the front to the scapulae ; generally 
the seat of the pain is sensitive to pressure, and 
when the arms are moved. 

Back. Here we meet a new variety of symp- 
toms. Sticking and jerking pains pressing between 
the scapulae and extending thence through to the 
epigastrium, when sitting ; pain in the lumbar and 
sacral region, as if beaten ; stiffness, tearing and 
tenderness in the joints and muscles of the lumbar 
region, which prevent motion and stooping; these 
are felt most when standing or sitting, and not so 
much when lying. 



BRYONIA ALBA. 



99 



Extremities. In the extremities we have stitch- 
ing pains in the region of the large joints, as in 
the shoulder, over the trochanter, and at the knee, 
— all greatly aggravated by motion, touch, or any 
jar or shock. Drawing and pain, as if luxated, in 
the medium and smaller joints. 

The limbs and the joints swell, become red, 
and are very sensitive to touch or motion. The 
pains are relieved by warmth. 

Skin. Various eruptions. Small red spots on 
various parts of the body ; some with sensibility, 
and not disappearing on pressure ; some burning, 
and disappearing on pressure. 

Sleep. Great sleepiness by day, with yawning, 
lassitude, stretching, etc. Yet, at night, the prover 
cannot sleep, because of the tumultuous course of the 
blood, anxiety and heat. A concourse of anxious 
thoughts keeps the prover awake till three or four 
a. m. Sleep full of dreams. Often a prattling and 
muttering delirium. Also, sleep-walking has been 
observed under the action of Bryonia, and has been 
cured by it. 

Fever. In the fever which Bryonia produces, 
cold predominates. Coldness and shivering over 
the whole body. Heat often only internal, or on 
single parts of the body, and it is conjoined with 
great thirst. So, indeed, is the chill. Sweat on 
slight exertion, even when walking in the cool air. 
It is frequent at night, and is often sour. 

Disposition. Anxious, peevish and hasty. 



IOO 



BRYONIA ALBA. 



GENERAL ANALYSIS. 

1. Vital Force. That Bryonia exerts, in some 
respects, a depressing action on the vital force, 
appears from its effect on the sensorium, which is 
depressed and benumbed ; there is a decided sensa- 
tion of weakness and lassitude ; the arms incline to 
sink by one's side; the limbs move but sluggishly. 
This sensation of lassitude is most marked early in 
the morning, as though the night's sleep had 
brought no refreshment. The least exertion seems 
to use up the forces of the body. 

Nevertheless, this prostration is not excessive, 
nor is it universal. For the disposition is not 
indifferent, as might have been expected ; on the 
contrary, the prover is hasty and peevish. Again, 
the special senses are not materially affected ; the 
sphincters are not relaxed, nor do any invol- 
untary muscles seem to be greatly embarrassed 
in the exercise of their functions. There is no 
laxity of fiber, such as is shown by the occurrence 
of involuntary excretions. 

The depressing effect seems to be confined to 
that part of the nervous system which presides 
over voluntary motion, and over the operations of 
the mind. 

2. The Organic Substance of the body is 
affected as follows: The secretions from the intesti- 
nal surfaces are diminished ; the capillary circula- 
tion appears to be somewhat impeded in the mucous 
membranes, but is particularly so in the serous 



BRYONIA ALBA. 



IOI 



membranes which line the closed cavities of the 
pleura, peritoneum, pericardium, and joints. As a 
sequel of this impediment we have effusion (so 
called) into these cavities. 

3. Sphere of Action. The action of Bryonia, 
as appears from the proving, is exerted chiefly 
upon the nervous system of animal life, presiding 
over ratiocination and voluntary motion ; upon the 
gastro-intestinal region, producing various perver- 
sions of digestion, a deficient intestinal secretion 
and a form of constipation, and, moreover, the 
symptoms of a well-marked hepatitis. Upon the 
respiratory mucous membrane, the action of Bry- 
onia, though evident, is subordinate. The serous 
membranes of the large cavities, and of the joints 
and the ligaments, are eminently affected. Finally, 
the female sexual organs are in such wise affected 
that menorrhagia is produced, the discharge being 
florid. 

4. Sensations. The sensations peculiar to Bry- 
onia are stitching, lancinating pains, — such pains, in 
fact, as usually attend and characterize acute affec- 
tions of the serous and fibrous tissues. Drawing 
pains are analogous to these. In addition, we note 
the peculiar sensations of lassitude in the limbs 
that have been already described. It must not 
be forgotten that many other remedies likewise 
produce stitching, lancinating pains, — as Squilla, 
Ranunculus bulbosus, Asclepias. 

5. Periodicity. A disposition to a recurrence 
of the pains in the morning early, not immediately 



102 



BRYONIA ALBA. 



on awaking (as with Lachesis), but on first moving- 
after waking. 

6. Peculiarities. The great feature character- 
istic of the Bryonia symptoms is their aggravation 
by motion and touch. This applies to all, except 
a few isolated symptoms, which it is evident, from 
the context, are purely nervous. 

It is also noteworthy, that the seat of the sub- 
jective pain soon becomes objectively sore, and 
then swollen and red. 

The pains of Bryonia are, in general, relieved 
by warmth and aggravated by cold. 

They are aggravated by mental excitement. 

PRACTICAL APPLICATIONS. 

Hahnemann mentions the importance of Bryonia 
in the treatment of various kinds of fevers, and 
refers to his treatment of a malignant typhus that 
was epidemic in Saxony in 1813, after the retreat 
of the French army. This will be spoken of when 
we treat of Rhus toxicodendron. 

Hahnemann recommends Bryonia in certain 
kinds of abdominal cramps in women, of course, 
when the symptoms correspond. 

Head. Seeing the action of the Bryonia on 
the serous membranes one might infer that it 
would occupy a prominent place in the treatment 
of meningitis. But this inference is not justified 
by the symptoms. They represent a fever too 
asthenic to correspond with any form of idiopathic 
meningitis. 



BRYONIA ALBA. IO3 

In repercussed eruptions, however, as, for exam- 
ple, during the course of an exanthematous fever, — 
scarlatina or measles, — when the eruption has dis- 
appeared, and the sensorium becomes immediately 
affected, Bryonia has often done excellent service. 
The oppression of the senses, the general prostra- 
tion, the peculiar form of fever, consisting of pre- 
dominant coldness, first a chill and then a fever, 
mixed up of chill and heat, with a small pulse, 
and which never, even when the heat is greatest, 
becomes very full or hard, — these symptoms corre- 
spond well to the kind of case to which we refer. 

But it is only in a certain class of cases of 
repercussed exanthemata that Bryonia is indicated 
and useful, viz., where the sensorium and the sys- 
tem of animal life are depressed, benumbed, but 
the functions not perverted. There is another class 
in which they are perverted, and in which, conse- 
quently, convulsions more or less complete occur. 
In such cases Cuprum aceticum (or metallicum) is 
likely to be indicated, a fact for the knowledge of 
which we are indebted to Dr. G. Schmidt, of 
Vienna. In other cases of this kind, without fever 
or disturbance of the general system, the entire 
sensorial life is suspended. Here Hellebore may 
be required, as Hahnemann has shown in his intro- 
duction to the proving of that drug. Or, again, 
together with this suspension of sensorial life, there 
may be signs of effusion within the cranium ; the 
patient lies like an animate but not intelligent log; 
the pupils are dilated ; the eyes converge or 



104 BRYONIA ALBA. 

diverge ; and here Zincum metallicum will some- 
times save the patient. I made this observation in 
1853, in a case of scarlatina. About the same 
time, and unknown to me, Dr. Elb, of Dresden, 
published some similar cases in the " Allgemeine 
Homceopathische Zeitung." 

Under these circumstances the vital processes 
move very slowly, and I believe it is necessary to 
repeat the Zinc frequently, and to continue it for 
many days. 

Epistaxis. Bryonia has been named as a rem- 
edy. The blood is florid. The epistaxis occurs in 
the morning, often waking the patient from sleep. 
It is often a concomitant of suppressed menstrua- 
tion, or where the symptom accompanies a case of 
typhoid fever. 

Fevers. In the fevers marked by gastro -intes- 
tinal localizations, such as bilious remittent, some 
forms of intermittent and some forms of typhus 
fever, Bryonia has done good service. It compares 
with Eupatorium and Rhus toxicodendron, and with 
Nux vomica and Mercurius. 

The fever is marked by gastro-hepatic compli- 
cations, resembling the symptoms. The headache 
is a splitting pain through the temples, and at the 
same time, more severely, in the occiput. Oppres- 
sion at the pit of the stomach and tenderness 
there ; vomiting of food, mucus and bile, stitches 
in the hypochondria, and soreness and tension in 
the hepatic region, along with dry cough and 
decided constipation, without any desire for evacu- 



BRYONIA ALBA. 



ation of the bowels. Together with these local 
symptoms there are frequent short chills, alternat- 
ing or mixed up with heat of the body ; a pulse 
small and frequent, but somewhat hard. Add to 
the above a slimy and bitter taste, aversion to 
food, eructations, pains in the back and limbs, 
much aggravated by touch and motion, together 
with dullness of the sensorium, and aversion to 
noise and to mental exertion, and we have a 
picture of the form of fever for which, whether 
remittent or intermittent, Bryonia is appropriate. 

Similar symptoms often characterize what is pop- 
ularly called "a bilious attack." These "attacks" 
are very common in persons who have for years 
been accustomed to take frequent doses of calomel 
or of blue mass for headache and " biliousness." 
And we are often called upon to supply a substi- 
tute for these drugs. In the majority of these 
cases Bryonia is the remedy. If early resorted to, 
it will generally break up the attack ; and a repe- 
tition of this treatment rarely fails to destroy a 
tendency to its recurrence. 

Bcenninghausen gives the following picture of 
the Bryonia fever : " Pulse hard, frequent and 
tense. Chill and coldness predominate, often with 
heat of the head, red cheeks and thirst. Chill, 
with external coldness of the body. Chill and 
coldness most at evening, or on the right side of 
the body. Chill more in the room than in the 
open air. 

" Dry, burning heat, for the most part only inter- 



io6 



BRYONIA ALBA. 



nally, and as if the blood burned in the veins. All 
the symptoms are aggravated during the heat. 

" Much sweat. Easy sweating, even from walk- 
ing slowly in the cold, open air. Copious night 
and morning sweats. Sweat sour, or oily." 

Hahnemann gives the following groups of symp^ 
toms, as characterizing those cases of typhus for 
which he gave Bryonia so successfully : 

" The patient complains of dizziness, shooting 
(or jerking-tearing) pains in the head, throat, chest, 
abdomen, etc., which are felt particularly on moving 
the part, in addition to the other symptoms, the 
haemorrhages, the vomiting, the heat, the thirst, 
the nocturnal restlessness," etc. 

In acute hepatitis it is very evident, from the 
symptoms, that Bryonia may be a most valuable 
remedy. Experience has confirmed the indication. 

Bryonia is also a remedy for constipation, 
being, as Hahnemann remarks, one of the few 
remedies of which the primary action is to diminish 
the intestinal excretion, and likewise the peristaltic 
action of the intestine. 

It differs from Nux vomica, as we shall see, in 
this respect, that the action of the intestine is 
diminished. Nux vomica does not diminish the 
action of the intestine. It rather increases it, but 
at the same time renders it inharmonious and spas- 
modic, a hindrance, therefore, and not a help to 
evacuation. This is the reason why the constipa- 
tion characteristic of Nux vomica is accompanied 
by frequent ineffectual desire for stool, the action 



BRYONIA ALBA. IO7 

of the intestine being irregular and spasmodic, and 
the constipation resulting from this irregularity of 
action, and not from inaction. Bryonia has nothing 
of this. Under its influence the intestinal activity is 
really diminished, — there is no desire for stool. As a 
remedy for constipation, Bryonia is analogous to 
that other valuable remedy for the same trouble — 
Veratrum. 

It has been already remarked that Bryonia is 
our great remedy in the treatment of vicarious 
menstruation — a perversion of function which is 
not so rare as has been supposed. At the period 
when the menstrual discharge should naturally take 
place, there occur haemorrhages from some other 
parts of the body, as from the nose, mouth or 
lungs. I have seen, under such circumstances, 
likewise, haemorrhage from the eye, the ear, and 
once from the nipple. These vicarious discharges 
are not difficult to distinguish from haemorrhage 
attending and consequent upon diseased conditions 
of these organs themselves. If, for example, about 
the time of menstruation, this phenomenon not 
occurring, a copious expectoration or vomiting of 
blood take place, without any other symptoms of 
disease of the lung or stomach, — if it last two or 
three days, with no greater disturbance of the gen- 
eral health than commonly attends menstruation, — 
if it then cease, leaving no sign of disease in the 
organ apparently affected, and, if it recur again 
after the usual menstrual interval, there can be no 
reasonable doubt of the nature of the trouble. 



io8 



BRYONIA ALBA. 



Clinical experience has shown that Bryonia gener- 
ally cures these cases. 

About the third day after confinement, women 
are liable to chill and an access of fever, just when 
the mamma begins in earnest the performance of 
its peculiar function. Experience has shown Bryo- 
nia to be one of our most valuable remedies in 
this condition. The correspondence of symptoms 
indicates this ; for, the " milk fever " is one in 
which chill predominates ; it is a mixture of chill 
and fever, the former much in excess, and, more- 
over, the gland, which is the seat of pain, becomes 
rapidly sore and sensitive to touch or motion. In 
addition, there are drawing tearing pains in the 
limbs and a headache resembling that of Bryonia. 
Bryonia is likewise our foremost remedy in inflam- 
mation of the mammae during: lactation. 

A word of caution, bearing on the diagnosis of 
the latter affection, may not here be inappropriate. 
It is of the utmost importance to avoid mistaking 
symptoms of exhaustion of the supply of milk in 
the gland for symptoms of commencing inflamma- 
tion, and treating, with medicine, a condition which 
should be met by rest of the organ and an appro- 
priate diet. 

In primiparse the secretion is often established 
tardily, and the milk fever is severe. For this 
reason the patient is apt to be kept on a very low 
diet, with a view of preventing inflammation of the 
mamma and, for the same object, the child is 
applied to the breast at very short intervals, in 



BRYONIA ALBA. IO9 

order to prevent " accumulation of milk in the 
gland," "to keep it free." Under these circum- 
stances, the supply of milk is apt to be scanty. 
If, now, the child be vigorous, the supply will soon 
be exhausted, and the child will " draw upon a 
vacuum." Very soon an acute dragging pain is 
experienced by the mother, extending from the 
nipple through the gland and the thorax to the 
scapula. It would be a sad mistake to regard this 
as always a sign of existing inflammation, to still 
farther curtail the diet and to resort to medication. 
It is not always a sign of inflammation, it is a 
"dragging on the milk-tubes." The diet should be 
increased in its nutritive qualities, and directions 
given to apply the child less frequently to the 
breast, and to remove it as soon as this peculiar 
pain begins to be felt. This is very important ; 
for, if the "dragging" be allowed to continue long, 
and be often repeated, it will produce inflammation, 
first of the nipple and subsequently of the gland. 
This is the origin of perhaps a majority of the 
cases of " sore nipples " met with in practice, and 
attention to these precautions constitutes one of the 
best preventives of that distressing affection. 

It should be observed, however, that cases 
sometimes occur, in which, as soon as the infant 
begins to nurse, the patient experiences severe 
acute dragging and stitching pain, extending from 
the extremity of the nipple to the scapula, and 
rendering the pain of nursing almost unendurable, 
and this, too, when there can be no reason to sus- 



IIO BRYONIA ALBA. 

pect a deficiency of milk. Indeed, the pains set 
in as soon as the child begins to nurse, and 
not, as in the case before described, after the child 
has already nursed, for a time, satisfactorily. These 
are cases of irritable nipple, and they often result 
in mammary abscess, because the mother cannot 
endure the pain of having the breast freed from 
the milk that is secreted. Such cases find their 
best remedy, as I learn from Professor Guernsey, 
of Philadelphia, in Croton tiglium. But if the 
pains come on and exist only or chiefly during the 
interval between nursing, they are relieved by 
Phellandrium aquaticum (Gross). 

On the respiratory organs the action of Bryonia 
is very emphatic. 

Dr. Wurmb says of it: "Although Bryonia be 
not so often administered in diseases of the mucous 
membranes as in those of the serous and fibrous 
tissues, it is, nevertheless, in the former, a very 
important remedy. Its action on all the mem- 
branes must be a very extensive one, because of 
its powerful influence upon the processes of secre- 
tion and absorption, and because the mucous 
membranes, in particular, belong to those organs 
by means of which these operations are, for the 
most part, carried on. 

"The results of provings show that Bryonia 
produces powerful irritation in the mucous mem- 
brane of the respiratory organs. This condition is 
important, not only inasmuch as it enables us to 
designate Bryonia as an important remedy in acute 



BRYONIA ALBA. 



I I I 



bronchial catarrh, but also as giving- us a point 
d'appui in studying the remedy. For experience 
teaches us, on the one hand, that the more violent 
forms of catarrh almost always involve the pleura, 
causing stitch in the side, and, on the other hand, 
that stitching pains almost always yield, and in a 
short time, to Bryonia. 

" We lay great stress on the fact that in the 
Bryonia catarrh the mucous secretion is diminished, 
because a great majority of the symptoms which 
are considered to indicate Bryonia derive their sig- 
nificance from this fact, and it will serve to keep 
them in memory. They are : hoarseness, hacking 
cough, which sets in especially in the morning and 
evening, and is generally dry or yields but a little 
tenacious mucus (which is sometimes streaked with 
blood), and which sometimes, through its violence, 
causes retching and actual vomiting. As rarely 
failing concomitants of the Bryonia cough, we have 
stitching pains in the throat and chest, and press- 
ing pains in the head." 

In the bronchial catarrh, with scanty secretion, 
and attended by dyspncea and nervous erethism, 
to which infants are subject, and which is often 
mistaken for true pneumonia, Bryonia is a most 
valuable remedy. In a subsequent stage of the 
same affection, when the secretion has become 
very abundant, every paroxysm of coughing pro- 
ducing nausea and copious vomiting of mucus, with 
dyspnoea, exhaustion and sweat, Ipecacuanha is 
likely to be required. In former days, before I 



I 12 



BRYONIA ALBA. 



learned to distinguish sharply between the indica- 
tions for these remedies, I used to give them, as 
was and is so commonly advised and practiced, in. 
alternation, — a slovenly practice which cannot be 
too strongly condemned. Each of the remedies has 
its place in the appropriate stage of the malady. 

In the pneumonia of adults, especially in that 
form in which the deposit or exudation is scanty 
and fibrinous, Bryonia is the remedy most fre- 
quently required. So true is this, and so valuable 
is Bryonia in this case, when indicated, that some 
practitioners have not hesitated to say that Bryonia 
is the sole and all-sufficient remedy for pneumonia, 
and that they give nothing else. This view, how- 
ever, restricts the idea of pneumonia to one path- 
ological form, ignoring that form in which the 
exudation is not purely fibrinous, and in which 
Phosphorus or Tartar emetic is likely to be 
indicated, as we shall see when we come to 
Phosphorus. 

A reference here may be permitted to the sin- 
gular fact that whereas, in New England, where 
pneumonia is frequently met with, more than one 
busy practitioner places his whole reliance on Bry- 
onia in pneumonia, and claims to cure every case 
with it; in Vienna, on the other hand, where pneu- 
monia is still more common, Dr. Fleischmann reeards 

o 

Phosphorus as the specific, and uses it almost 
exclusively. 

Admitting the looseness of the practice, which, 
in any locality, looks to one remedy exclusively as 



BRYONIA ALBA. 



"3 



the specific for any disease whatever, may it not 
be that the character of the pneumonia, in the two 
regions, is radically different, depending on differ- 
ences in the constitutions and habits of the races 
in the two countries ? Be this as it may, the facts 
are a warning not to prescribe on the basis of the 
name of the disease. 

Important as is the action of Bryonia on the 
regions already designated, it is still more marked 
in the serous and fibrous tissues. 

The stitching pains in the thorax and abdomen, 
especially the stitch in the intercostal regions on 
taking a deep inspiration, all point to the efficacy 
of Bryonia in pleuritis, an indication which expe- 
rience has confirmed. It is believed to be more 
suitable for pleurisy of the right side. 

In pericarditis, also, it is valuable, though per- 
haps less frequently indicated than Spigelia. (As- 
clepias tuberosa.) 

In its relations to affections of the pleura, 
Bryonia is resembled by Spigelia, Squilla, Ranun- 
culus bulbosus and Kali carbonicum, and amongst 
the new remedies, Asclepias tuberosa. 

In rheumatism, Bryonia is one of our most 
important remedies. Its symptoms of the extremi- 
ties simulate a muscular rheumatism, with moderate 
fever ; while the symptoms of the joints show it to 
be still more appropriate to articular rheumatism. 

The joints are much swollen and are reddened ; 
streaks of red extending up and down the limb. 
They are very sensitive to touch, and are especially 
9 



H4 BRYONIA ALBA. 

painful during motion, the pain being less the more 
perfect the repose. Dr. Wurmb gives the follow- 
ing indications : " The fever not very violent, or, 
if so at first, much diminished; the rheumatism 
does not change its location; the local phenomena, 
especially the swelling and pain, very violent ; the 
irritation of the skin but slight; the redness not 
very great." The aggravations as to time are in 
the morning some time after waking, and in the 
evening. The pain is of a sticking and tearing 
character. 



EUPATORIUM. 



HIS drug, which has hardly as yet an estab- 



is a much used and highly prized " domestic " 
remedy, has been but imperfectly studied, and we 
have nothing approaching to an exhaustive knowl- 
edge of its properties and capabilities. Enough is 
known, however, to give it rank beside Bryonia in 
regard of its febrile and gastro-hepatic symptoms. 

Eupatorium perfoliatum — thorough wort or bone- 
set — is popularly used as a diaphoretic (a hot 
infusion in frequent, moderate doses), or as an 
emetic (hot infusion, large doses), or as a tonic 
(cold infusion, small doses). 

Its history and its uses by allopathic and 
eclectic physicians are well detailed in Dr. Hale's 
work. 1 

Eupatorium is said to have been a principal 
remedy for intermittent fever with the Indians. 

Dr. Anderson, of New- York, in 1813, pub- 
lished a number of cases of intermittent fever 
successfully treated with it in the City Hospital. 
He proposed it, therefore, as a substitute for Cin- 




the pharmacopoeia, although it 



New Remedies," etc., p. 159 et seq. 



I 1 6 EUPATORIUM. 

chona bark. Subsequent experiments with it in 
that hospital were not successful and the remedy 
fell into disrepute. 

This is the history of every drug in the allo- 
pathic materia medica. There can be no doubt 
that the Eupatorium did really cure the cases 
which Dr. Anderson reported. But there was, assur- 
edly, some peculiarity about these cases, by virtue 
of which they exactly corresponded to Eupatorium. 
The cases in which it was tried unsuccessfully, 
unquestionably, did not possess this peculiarity, 
whatever it was, and which must be the character- 
istic of Eupatorium. But the physicians who were 
testing the remedy took no note of this ; they 
regarded all cases as virtually alike, because to all 
of them the name "intermittent" could be applied. 
So regarding them, and taking no note of any 
peculiarities wherein one case differed from another, 
they could not of course perceive why Eupatorium 
might correspond to one case and cure it, and not 
to another. 

The number of cases of intermittent fever to 
which Eupatorium is appropriate is not very large, 
except during certain seasons, when an epidemic 
requiring it may prevail (as was the case in some 
parts of the State of New-York, in the autumn 
of 1865). 

The first proving of Eupatorium was made in 
Philadelphia, and was reported by Dr. W. Wil- 
liamson to the American Institute of Homoeopathy 1 
in 1847. Its great action is upon the muscular 

'"Transactions," vol. I. 



EUPATORIUM. 



117 



system (or fibrous tissues), producing great soreness 
and aching, and upon the gastro-hepatic system, 
producing a condition resembling what is known 
as a " bilious state." 

It produces intense headache, throbbing and 
great sense of internal soreness in the forehead 
and occiput, with a sensation of great weight in the 
occiput, distress and painful soreness in the top 
and back of the head. 

Soreness of the eyeball ; redness of the face, 
with dry skin. 

Tongue coated whitish or yellow. 

Loss of appetite ; thirst for cold water. 

Eructations tasteless or bitter. 

Vomiting after drinking ; vomiting of bile, with 
trembling and with pain in the epigastrium. 

Nausea and sense of extreme prostration (this 
is not real prostration). 

Soreness around the epigastric zone ; soreness 
and fullness in the region of the liver. 

Constipation ; urine high-colored and scanty. 
Roughness and rawness in the trachea. Hacking, 
dry cough, with flushed face ; the patient supports 
the chest with the hand (like Bryonia). 

Weakness in the small of the back ; deep-seated 
pain in the loins, with soreness on every motion ; 
pain in the back and lower extremities. 

Soreness and aching in hands and wrists, as if 
broken and dislocated ; the same in arms. Stiffness 
and soreness of lower extremities, as if beaten, 
worse on motion and touch. 



n8 



EUPATORIUM. 



Fever, commencing generally in the morning; 
thirst begins several hours before the chill, and 
continues during chill and heat. There is vomiting 
of bile at the end of the chill. 

Durino- the heat the face is of a dull, mahogany- 
red color, and the eye glistens, the sclerotica being 
yellow. 

It is a distinguishing peculiarity that little or 
no sweat follows the hot stage. 

The peculiar headache, the soreness of the eyes 
and their yellowness, the yellowish-red face, the 
vomiting of bile, with nausea and prostration, the 
soreness in the region of the liver, the constipation, 
etc., are one group of symptoms. The internal 
soreness and the external soreness all over the 
body, from head to foot, constitute another group. 
These two groups together furnish an indication for 
Eupatorium in certain forms of "bilious fever" (in 
the first stage), too strong to be questioned. 

The absence of much perspiration after the 
heat, showing an imperfect resolution, points to the 
type of fever as the remittent. 

Experience has confirmed these views. I regard 
the severe bone pains and the absence of much 
sweat as especially characteristic. 

The symptoms of the gastro-hepatic region, and 
the character and aggravations of the pains in the 
body and extremities, very closely resemble those 
of Bryonia. But a broad distinction at once 
appears when we consider the perspiration which, 
under Bryonia, is profuse and easily provoked, 



EUPATORIUM. HQ 

while, under Eupatorium, it is scanty or absent. 
Again, the Eupatorium pains make the patient 
restless ; those of Bryonia make him keep very 
still. 

Rhus toxicodendron produces pains and aching 
in the limbs ; but these pains are worse during 
repose, and they keep the patient restless, con- 
stantly changing his position, whereas those of 
Eupatorium are not aggravated by repose. 

R. D., a stout mechanic, thirty-five years old, of 
dark complexion, went into an ice-house one very 
warm morning in August, to get a piece of ice. 
Charmed with the coolness of the place, he fool- 
ishly remained there for a quarter hour or longer. 
Suddenly he felt chills creeping over him and 
became quite faint. He left the ice-house as 
quickly as he could and went home. In an hour 
he had an exceedingly severe chill, lasting several 
hours. This was followed by burning fever, which 
continued without abatement until the following 
morning, when it gave place to a severe chill. 
As this chill was passing away I first saw the 
patient. 

He had already become hot externally; his face 
was of a dull, red color ; the eyes glistened, and 
the sclerotica^ were yellowish red. The tongue 
had a thick, yellowish fur; there was intense head- 
ache in the occiput — an insupportable heaviness. 
Nausea and frequent effort to vomit, extreme ten- 
derness in the epigastrium, fullness and tenderness 
in the hepatic region, with stitches and soreness 



120 



EUPATORIUM. 



on moving and coughing ; intolerable aching in 
the back and limbs, "as if the bones were 
broken." Urine scanty and of a dark mahogany 
color ; a hard, dry cough and some dyspnoea. 
The patient, although in great pain, lay quiet. 

I had no Eupatorium, but there was a swamp 
near the house, and I soon found the plant From 
the juice pressed from a few leaves I prepared, with 
water, the third attenuation, and directed it to be 
taken in drop doses, every three hours until 
marked improvement was observed. 

In about ten hours the fever was gone ; the 
chill and fever never recurred, and next day the 
patient was free from pain. On the third day I 
found him convalescent. 

In many cases of influenza, a review of the 
symptoms will show why Eupatorium proves, as it 
does, a speedy curative. 



RHUS TOXICODENDRON ; 



OR, RHUS RADICANS. 

THESE two plants are now regarded by botan- 
ists as identical, differing only in their modes 
of growth. The former was proved by Hahne- 
mann ; the latter by the late Dr. B. F. Joslin. I 
can perceive no essential differences in the symp- 
toms ascribed to them by provers. For ten years 
I have used them interchangeably in my practice, 
and have seen no differences in their effects. I 
shall therefore treat them as identical substances. 

This plant is a native of North America. It was 
known to the Indians as possessed, of medicinal 
properties. Dufresnoy, a French army surgeon, pub- 
lished in 1 788, " An account of its supposed virtues 
in the cure of cutaneous eruptions, and of nervous 
paralysis." He also, as well as the traveler Kalm, 
described its property of causing inflammatory swell- 
ing of the skin, followed by vesication, in persons 
who touch the leaves, and even in susceptible persons 
who are exposed to its exhalations at night. 

Indeed, it is well known that contact with the 
leaves of the Rhus radicans or "poison vine" pro- 



122 



RHUS TOXICODENDRON. 



duces, not merely in the parts touched, but also 
often in other parts of the body, as the neck and 
face, a swelling, with redness, oedema and vesica- 
tion, that bears a marvelous resemblance to 
vesicular erysipelas. This eruption is attended by 
constitutional symptoms which resemble those of 
erysipelas. It is well known, too, that in this form 
of vesicular erysipelas, homceopathicians long ago 
found reason to look upon Rhus toxicodendron or 
radicans as their most valuable remedy. The 
striking confirmation of the homoeopathic law of 
cure which these facts afford, has caused some 
bitter opponents of homoeopathy actually to thrust 
Rhus out from the materia medica. We find Dr. 
Stille, after giving a very imperfect summary of 
the effects of Rhus and the opinions held respect- 
ing it, coolly remarking: "It, however, does not 
really appear to deserve sufficient confidence as a 
medicine to entitle it to retain a place in the 
materia medica." 

Very different are the judgment and method of 
Prof. Trousseau, who, though no advocate or friend 
of homoeopathy, is yet too wise and honest a man 
to refuse to learn from an opponent. 

He relates an interesting proving of Rhus : 
" Dr. Savini applied two drops of the .juice of 
Rhus radicans to the first phalanx of his forefinger; 
he left it there only two minutes, and yet, at the 
end of an hour, it had produced two black spots. 
Twenty-five days afterward, the following symp- 
toms suddenly manifested themselves : great heat 



RHUS TOXICODENDRON. 123 

in the mouth and gullet ; rapidly increasing swell- 
ing of the left cheek, of the upper lip and of the 
eyelids. The following night, swelling of the fore- 
arm, which had acquired double its normal volume; 
the skin was rough, the itching intolerable, the 
heat very great, etc. 

" This singular action of Rhus radicans," con- 
tinues Trousseau, " upon the human economy, has 
induced the homceopathists to use it in skin dis- 
eases ; but already before them, Dufresnoy, of 
Valenciennes, had published a pamphlet in which 
he extolled the virtues of this plant against cuta- 
neous diseases, and subsequently against paralysis. 

" Since that time a number of essays on this 
subject have appeared in medical periodicals, and 
many respectable physicians have confirmed Dufres- 
noy's experiments. 

" We have ourselves," continues Trousseau, 
"often used Rhus radicans for paralysis; but the 
experiments we have made in skin diseases are too 
few and too little conclusive to admit of our 
referring to them here. 

"The only forms of paralysis which we have 
seen treated by M. Bretonneau, of Tours, and 
which we have ourselves treated, are those of the 
lower extremities which succeeded a concussion of 
the spinal marrow, or a lesion of that organ, which 
did not destroy its tissue. On this point we have 
collected facts enough to place beyond a doubt the 
therapeutic efficacy of Rhus radicans." 1 

1 Trousseau et Pidoux, "Traite de Therapeutique ct Materia Medica," 
vol. i., 787, 788. 



124 



RHUS TOXICODENDRON. 



We shall see that the symptoms clearly point 
to the use of Rhus in paralysis of the lower 
extremities. The powerful testimony of Trousseau 
is an indorsement of our law for the selection of 
remedies. 

Our knowledge of the positive effects of Rhus 
toxicodendron upon the human organism is derived 
from the proving by Hahnemann and his pupils, 
published in vol. n. of the " Materia Medica Pura," 
and from the proving of Rhus radicans conducted 
by the late Dr. Joslin, and published by him in the 
" Philadelphia Journal of Homoeopathy," and in 
" Jahr s New Manual"; also later in the "American 
Homoeopathic Review." 

Hahnemann, in the introduction to his proving, 
remarks that a careful study of the symptoms will 
enable us to discover many characteristic peculiar- 
ities of this remarkable and very precious drug, 
one of which (possessed by very few other drugs, 
and by none in so high a degree), he describes 
as follows : "It excites the strongest symptoms 
when the body or the limb in question is in the 
greatest repose and is kept as free as possible from 
all motion." 

He further remarks that "whoever has studied 
the symptoms of Bryonia will observe a great 
similarity in them to the symptoms of Rhus toxi- 
codendron, and at the same time a great contra- 
riety. Thus, for example, how remarkable is the 
aggravation under Bryonia by motion, and the 
amelioration during repose, of the very same symp- 



RHUS TOXICODENDRON. 



toms which under Rhus are ameliorated by motion 
and aggravated by repose." 

Taking a general view of the action of Rhus 
before we proceed to examine its special action 
upon each apparatus and organ of the body, we 
find : The sphere of action of Rhus to be exten- 
sive. Upon the system of nutrition it acts as a 
depressent, retarding all the functions. The secre- 
tion of the mucous membranes is altered and 
increased, as is shown by diarrhoea and by the sputa 
attending the cough as well as by secretions from 
other mucous membranes. The lymphatic glands 
are affected throughout the body, as, for example, 
the cervical, the inguinal and the mesenteric, which 
are all enlarged and inflamed. Emaciation is pro- 
duced. Perspiration is abundant and is sour. 

From the character of the fever symptoms which 
it produces, it would be reasonable to infer that 
Rhus affects the composition of the blood. 

But it acts quite as decidedly upon the system 
of animal life. The sensorium is depressed, and 
the capability of the mind for continuous thought is 
absolutely destroyed; thus a patient meaning to 
write the number 12 will write the figure 1, but 
cannot recollect the figure 2 which should follow 
it. Like the typhus patient, who begins his sen- 
tence coherently and intelligibly, but allows it to 
dwindle away into an inarticulate murmur. 

Listlessness and horrible depression possess the 
mind. This marks a more profound depression 
than that produced by Bryonia, for the latter 



126 



RHUS TOXICODENDRON. 



results in fretful peevishness and irritability. Rhus 
has listlessness, a feeling of helplessness and pro- 
found despondency. A similar feeling pervades the 
whole apparatus of voluntary motion, expressing 
itself in a sense of physical prostration, of inability 
to move, of powerlessness, approaching paralysis. 
So great is this that, on first attempting to move 
after a repose of some length of time, the limbs 
tremble, the joints are stiff, and there seems to be 
actual inability to move. This condition is more 
pronounced in the lower extremities than in the 
upper. 

The special senses are dulled, but not perverted. 

The skin, as we shall see, is the theater on 
which are displayed some of the most powerful, 
characteristic and valuable properties of Rhus. 
Rhus, then, acts prominently on the mucous mem- 
branes, on the lymphatic glands, on the organs of 
animal life, and on the skin. To this list must be 
added the tissues which compose the joints. 

The sensations which are characteristic of Rhus 
are : 

Soreness, as if beaten ; this is felt in the mus- 
cles and in the neighborhood of the joints. 

Heaviness and pressure ; this is felt in the 
head and eyes and eyelids and in the limbs. 

Lassitude and languor and weight; felt in the 
extremities, especially the lower limbs. 

The action of Rhus may be summed up as fol- 
lows: It produces a kind of rheumatic affection of 
the muscles and ligaments, alleviated by motion ; a 



RHUS TOXICODENDRON. 



127 



paralysis aggravated by motion ; an apparent 
passive congestion of head, relieved by repose; a 
debility of the organs of nutrition, marked by defi- 
cient and depraved appetite and by tympanitis ; a 
serous infiltration of the cellular tissue in various 
parts, as face, fauces, genital organs, feet ; a vesic- 
ular eruption generally ; an acrid state of the 
secretions generally, as tears, nasal mucus, gastric 
mucus, intestinal mucus, urine, menstrual flow, 
contents of cutaneous vesicles ; general depression 
of sensorium. 

We shall gather evidence of these generaliza- 
tions as we proceed. 

Periodicity is not marked in the symptoms of 
Rhus. 

Peculiarities. The great and characteristic 
peculiarity of the symptoms of Rhus is that, with 
few exceptions, they occur and are aggravated 
during repose and are ameliorated by motion. 

This statement, however, requires some degree 
of explanation. In addition to the symptoms of 
Rhus which resemble paralysis, there are also 
groups of symptoms resembling muscular and artic- 
ular rheumatism. These rheumatic symptoms come 
on with severity during repose and increase as 
long as the patient keeps quiet, until they compel 
him to move. Now, on first attempting to move, 
he finds himself very stiff, and the first movement 
is exceedingly painful. By continuing to move for 
a little while, however, the stiffness is relieved and 
the pains decidedly decrease, the patient feeling 



128 



RHUS TOXICODENDRON. 



much better. But this improvement does not go 
on indefinitely. After moving continuously for a 
longer or shorter period and finding comfort therein, 
the paralytic symptoms interpose their exhausting 
protest, and the patient is compelled from a sensa- 
tion of lassitude and powerlessness to suspend his 
movements and to come to repose. At first this 
repose after long-continued motion is grateful, since 
it relieves, not the aching and severe pains, but 
only the sense of prostration. Before long, the 
pains come on again during this repose and the 
patient is forced to move again as before. 

This will explain seeming contradictions in the 
symptoms of Rhus. 

The amount of it is that the pains of Rhus 
are aggravated by repose and relieved by motion. 
But the paralysis and languor of Rhus, like all 
such symptoms always, when real, are relieved by 
repose and aggravated by long-continued motion. 

SPECIAL ANALYSIS. 

The sensorium is affected as follows : There is 
vertigo, which occurs when standing and walking ; 
but also when sitting and even comes on when lying 
down. In this particular it corresponds with the 
conditions of the rheumatic pains of Rhus toxico- 
dendron. It is described as if something kept 
going around in the head; one feels as if drunken, 
as though one would fall forward or backward. 
On rising in the morning, one can hardly support 
one's self. This is not only from dizziness but also 



RHUS TOXICODENDRON. 



I29 



from the paralytic condition and from the stiffness 
and lassitude which follow long repose. 

Excessive vertigo on lying down, with fear of 
dying. 

Memory is markedly impaired even for the 
most familiar facts. The thinking power almost 
suspended, with absence of mind. Head confused; 
he cannot write nor remember what it was he 
wished to write. 

Headache. Among the pains in the head, prop- 
erly so called, we notice first pressure, both in 
the temples and in the forehead and behind the 
orbits, where it feels sometimes like a wearisome 
pressure downward ; sometimes as if the eyes 
would be pressed outward ; sometimes as if the 
brain were pressed together from both sides. Also 
a radiating pressure in the temples, worse during 
repose ; sometimes a burning pressure in the tem- 
poral bone. 

The sensation most closely allied to the above 
is heaviness, which is felt in this way : that when 
the patient stoops . it seems as though he could not 
rise again. There is a sensation as if a quantity 
of blood shot into the brain ; as if a weight fell 
forward in the forehead and drew the head down- 
ward, or as if the head were being pressed asunder. 

Sometimes there is a tearing in the head in 
every part and direction ; or on awaking and open- 
ing the eyes a violent headache, as if the brain 
were torn, worse on opening the eyes. 

A singular sensation characteristic of Rhus is 
10 



I30 RHUS TOXICODENDRON. 

noted on shaking the head and when walking, 
when jarring the body, etc., namely, a sensation of 
swashing and jarring in the brain, and each step 
concusses the brain. China has a similar symptom. 
Externally the scalp is sore to the touch. There 
is itching on the scalp, face and lips, and the 
formation of a vesicular eruption. 

To recapitulate : The vertigo occurs when stand- 
ing and walking ; is worse when lying down, 
though there is a tottering when walking, with 
which, probably, the paralysis is connected. 

The pains in the head are pressure, heaviness, 
tearing and swashing. They affect chiefly the 
forehead, temples and post-orbital regions, and, 
unlike the rheumatic pains, are generally worse on 
motion, although some are aggravated by repose. 

Face. The face may be pale and sickly-look- 
ing, with the features distorted ; or red, and 
covered with sweat without thirst. As regards the 
skin, there has been observed an erysipelatous 
redness of the face, swelling of the face and eye- 
lids, with burning pain or itching.. On this surface, 
after a few days, vesicles make their appearance, 
which discharge and leave a fine, mealy scale. 
This resembles so exactly the vesicular erysipelas 
of the face that it is often mistaken for it. 

Eyes. In the eyes a burning pressing pain ; 
they itch and bite. The white of the eye is red- 
dened ; they lachrymate and are agglutinated in the 
morning. The lids smart, as if excoriated by the 
tears, or else they have a sensation of dryness. 



RHUS TOXICODENDRON. 



There is often a sensation of heaviness or of paral- 
ysis in the lids, so that they can hardly be kept 
open. 

As regards the sense of vision, there seems to 
be something like a veil before the eyes, preventing 
distinct vision. 

Ears. Earache and a feeling as if spme one 
were blowing into the ear. There is a whistling, 
a squealing noise heard, or a ringing when walk- 
ing, which changes to a loud resonance when 
lying down, as if the membrana tympani were 
burst. 

Nose. Nose-bleeding, the blood being dark ; 
it occurs at night ; also when stooping and when 
clearing the throat. A scabby eruption about the 
nares, with itching, burning pain. 

Cheeks and yaws. A peculiar phenomenon is 
noteworthy : A cramp-like pain in the maxillary 
joint, as if beaten, as if it would break, and on 
each motion of the jaw it cracks and snaps audi- 
bly. There is a constant desire to yawn, until it 
seems as though the jaw would break. (This cor- 
responds with, and is analogous to, the stretching 
and twisting so characteristic of Rhus.) 

The toothache of Rhus is a jerking pain ex- 
tending into the head. It is relieved by applying 
the cold hand. The gums burn and are sore. 
The teeth are loose. 

In the mouth a sensation of dryness, which 
persists notwithstanding all the patient may drink. 

In the throat a sensation of swelling, with 



I32 RHUS TOXICODENDRON. 

aching pain when speaking, and independently, but 
attended by sticking on attempting to swallow. 
There are also sticking pains when swallowing 
saliva or food, sensations of soreness in the muscles 
of the root of the tongue and when yawning; 
pressure on empty swallowing. 

The. action of Rhus on the digestive organs is 
not very characteristic. It produces a bitter, sour 
or coppery taste, a total loss of appetite, a sensa- 
tion as if the stomach were always full ; nothing 
tastes good. Or, on the other hand, a kind of 
canine hunger, along with which there is a soapy, 
slimy condition of the mouth ; everything tastes 
like straw, and there is an immediate feeling of 
fullness. Frequent eructations ; occasional nausea, 
relieved by lying down and by eating ; sometimes 
nausea and retching at night ; pressure in the epi- 
gastrium, as if swollen ; throbbing, cutting, pinching 
pains in the abdomen ; great accumulation of flatus 
in the abdomen, with great distention. 

Stool. As regards the stool, we notice : Con- 
stant tenesmus, with nausea, tearing and pinching 
in the intestines ; the stool is scanty, consisting of 
mucus, or a watery, jelly-like substance, yellow or 
streaked with white, frothy, and often mixed with 
blood. Before stool a burning in the rectum. 
After stool all pains are relieved. Itching and 
burning in the rectum, with smarting, blind haem- 
orrhoids. 

The urine is dark, soon becomes turbid, with 
a white sediment (probably urate of ammonia). It 



RHUS TOXICODENDRON. 



J 33 



is evacuated frequently with sticking pain in the 
bladder. 

With regard to the genital organs we find, as 
in various other distensible parts of the body, the 
characteristic effects of Rhus, viz. : Swelling, pro- 
duced by serous infiltration of the cellular tissue, 
redness of the cutis, followed by vesicular eruption, 
which forms a light scab or small white scabs. 
The moisture exuded is limpid and acrid. More- 
over, the natural secretions are acrid. Hence the 
menstrual flow which Rhus makes to appear earlier 
and more copiously than is normal, is acrid. 

. Respiratory Organs. Sneezing ; free nasal secre- 
tion. 

Hoarseness. 

Respiration impeded. Cough, dry, hacking, 
worse evening and before midnight, or in the 
morning after waking. 

Sensation of heat in the chest and of weakness 
there, hindering speech. Stitching pain here and 
there. 

It cannot fail to be remarked how much less 
action on the respiratory organs Rhus has than 
Bryonia. 

Sometimes violent palpitation, sometimes weak- 
ness in the cardiac region and a feeling of trem- 
bling in the heart. 

Neck and Back. In the region of the neck 
and back we find stiffness of the nape and entire 
neck, with tensive pain and crying out on moving. 
The sacral region is stiff when he moves, but 



134 



RHUS TOXICODENDRON. 



pains when sitting, as if he had been stooping 
and bending the back too much. Stitching and 
pressing pains. 

In the extremities we have, most frequently, 
sticking pains. They may occur in all parts. Also 
tearing pains, aggravated by hard labor. When 
felt of, the bones feel sore. The salient osseous 
processes, condyles, olecranon, etc., are sore to 
pressure. 

Drawing pains are frequent. They go from the 
elbow to the hand. In Dr. Joslin's proving of 
Rhus radicans a pain is described as following the 
ulnar nerve. I have twice met this in patierfts 
and relieved it permanently with a dose of Rhus 
radicans. Tensive pain ; aching and pains as if 
luxated are common under Rhus. They affect all 
parts of the extremities and all the joints. 

Besides the above pains and sensations there is 
a feeling of creeping, formication and numbness as 
if the fingers were asleep. This is allied to the 
paralysis. 

Also a sensation of great weakness in the 
limbs ; a trembling of the arms and fingers on 
moderate exertion; a heaviness and lassitude of the 
lower extremities so that one can hardly move. 

There is painless swelling of the feet at even- 
ing, evidently cedematous. 

Also swelling and pain of the axillary glands. 

Sleep. There is great sleepiness during the 
day, and also early in the morning, with indisposi- 
tion to rise and dress. Constant desire to lie 



RHUS TOXICODENDRON. 



!35 



down. Incessant yawning, spasmodic, fatiguing, 
and almost breaking the jaw. Yet the patient can't 
get asleep before midnight, partly from sheer wake- 
fulness, partly from heat and restlessness or anxiety; 
tumultuous coursing of the blood, without thirst. 

On going to sleep, shuddering and twitching in 
the body. The sleep is restless with tossing and 
unpleasant thoughts and dreams about the business 
of the day or of things recently done or heard. 
The gastric symptoms are apt to be felt or to be 
worse at night. 

Fever. The proving of Rhus is rich in fever 
symptoms. The cold fresh air is not tolerated ; 
it seems to make the skin painful. (This symp- 
tom is of inestimable value in treating rheumatic 
patients.) 

The chill occurs early in the morning. It is 
characteristic of the chill that it is accompanied by 
cough, dry and fatiguing. I have often cured 
intermittent with Rhus, guided by this symptom 
alone. More frequently the paroxysm is mixed up. 
External chill with internal heat, without thirst, 
followed by general sweat. The sweat often appears 
on the whole body, except the head and face. In 
this respect the opposite of Silicea. 

As regards the disposition, it is depressed and 
despondent, averse to all exertion, full of sad anx- 
iety and care-taking, depressed, lonesome and prone 
to weep ; anxiety is so great he thinks he shall 
die or lose his mind ; the forces sink ; he gets fits 
of trembling ; then comes restlessness ; the patient 



136 



RHUS TOXICODENDRON. 



can't sit still but must always keep moving; becomes 
fearful, thinks he has been poisoned ; the anxiety 
goes to such an extent that he feels as though 
he should take his own life ; at the same time a 
sense of dyspnoea and yet relief from deep inspi- 
rations. 

A better picture than this of the mental and 
moral condition which ushers in one form of 
typhoid or nervous fever — the erethistic as distin- 
guished from the torpid form — could hardly be 
conceived. 

We come now to the practical applications of 
Rhus, in which department, for lack of space, we 
shall restrict ourselves to its application in fevers, 
in rheumatism, in paralysis, and in cutaneous dis- 
eases, including the exanthemata and glandular 
affections. 

PRACTICAL APPLICATIONS. 

In fevers Rhus has had a most successful and 
extensive application. As the symptoms indicate, 
the forms of fever which require it can only be 
what used to be called the nervous fevers, and are 
now known as typhoid or typhus. 

Comparing it with Bryonia and Eupatorium, 
we miss at once the whole train of gastro-hepatic 
symptoms, the vomiting of bile, soreness and pain 
at the pit of the stomach, constriction around the 
epigastric zone, fullness and tenderness of the 
hepatic region, etc., which indicated those remedies 
in bilious remittent fevers. On the other hand, we 



RHUS TOXICODENDRON. 



J 37 



find Rhus producing some degree of tenderness 
of the abdomen, great flatulent distention of the 
abdomen, amounting to tympanitis, — occasional 
watery or mucous diarrhoea, — symptoms which, 
though not so strongly pronounced as similar 
symptoms are under Phosphoric acid, yet decidedly 
resemble the symptoms of typhoid fever, or, as the 
Germans call it, abdominal typhus, and indicate the 
use of Rhus in that disease. 

With this indication, the depressed and collapsed 
sensorium, the absent-mindedness, the inability to 
think of what one wishes to do or say, to remem- 
ber even familiar circumstances, the depression of 
spirits, the lassitude and actual muscular feebleness, 
exactly coincide. So do the restless nights and 
sleepy days, the mixed-up fever and the partial 
sweats which give no relief. 

Hahnemann, in writing of the epidemic of 1813, 
gave the following directions for selecting Rhus : 
" This fever has two principal stages : In the first 
period (which is all the shorter, the worse the 
disease is to be) there are present, full increased 
sensation of the pains usually present, with intoler- 
ably bad humor, sensation of heat in the body and 
especially in the head, dry feeling or actual dryness 
in the mouth, causing constant thirst, bruised feel- 
ing in the limbs, restlessness, etc. ; but in the 
second period, that of delirium (a quasi metastasis 
of the whole disease upon the mental organs), no 
complaint is made of all those symptoms, the 
patient is hot, does not desire to drink, he knows 



^8 RHUS TOXICODENDRON. 

not whether to take this or that, he does not know 
those about him, or he abuses them; he makes 
irrelevant answers, talks nonsense with his eyes 
open ; does foolish things, wishes to run away, 
cries aloud or whines, without being able to say 
why he does so; has a rattling in the throat, the 
countenance is distorted, the eyes squinting; he 
plays with his hands, behaves like a madman, 
passes faeces and urine involuntarily, etc. 

"In the first period of pain and consciousness, 
two remedies are of use and generally quite 
remove the disease at its commencement, — Bryonia 
alba and Rhus toxicodendron. If, for instance, 
the patient complain of dizziness, shooting pains in 
the head, throat, chest, abdomen, etc., which are 
felt particularly on moving the part; in addition to 
the other symptoms, the haemorrhages, the vomit- 
ing, the heat, the thirst, the nocturnal restlessness, 
etc., we give him a dose of Bryonia, and give 
no other medicine, nor even repeat the same as 
long as he continues to improve. 

" If now," he proceeds, — "if now, the amendment 
produced by the Bryonia goes off in the course of 
a few days ; if the patient then complains of shoot- 
ing pains in one or other part of the body while 
the part is at rest ; if the prostration and anorexia 
are greater; if there is harassing cough, or such a 
debility of certain parts as to threaten paralysis, we 
give a single drop of the Rhus toxicodendron. 

" Or the Rhus may be given at the very com- 
mencement, if the symptoms I have described 



RHUS TOXICODENDRON. 



139 



occur at the commencement of the attack. * * * 
Indeed, Rhus is suitable more frequently than Bry- 
onia in this disease, and hence can more frequently 
be used first and alone in treating it." 

Observe, first, the clear and sharp distinction 
which Hahnemann draws between the indications 
for Bryonia and Rhus respectively ; how carefully 
he advises us to give each remedy only when the 
symptoms which specially call for it are present in 
the case ; and how different these symptoms are ! 
Could you gather from this statement that Hahne- 
mann advises the giving of Rhus and Bryonia, in 
alternation, in typhoid fever? It would seem- to 
me impossible. And yet the majority of homceop- 
athicians will tell you, and the majority of works 
on practice will teach you, that the standard pre- 
scription in typhoid fever is " Bryonia and Rhus in 
alternation," and that this was recommended and 
used by Hahnemann! There is no better founda- 
tion for alternation in any case than there is for 
this assertion. 

Dr. Wurmb, in his " Clinical Studies of Typhoid 
Fever," has given us some exceedingly valuable 
summaries of the action of Rhus and its cognate 
remedies, so valuable that I cannot do better than 
to quote freely from his work. Speaking generally 
of the therapeutics of fevers, he says : 

" In typhoid epidemics, inasmuch as the cases 
present at given times and in given localities, apart 
from all special peculiarities of individual cases, a 
determinate and distinct general character, and are 



I40 RHUS TOXICODENDRON. 

thereby clearly distinguishable from those which 
occur at other periods and in other localities, we 
must regard it as our first problem to get an accu- 
rate knowledge of the character of the prevailing 
epidemic. 

"When we have done this, the second problem 
remains for solution, viz. : The discovery of the 
group of remedies which most closely corre- 
sponds in the similarity of their effects upon the 
healthy to the character of the epidemic. If we 
succeed in this, then is the most difficult part of 
our labor done ; for the number of remedies con- 
tained in this group cannot be very large, and it 
cannot consequently be very difficult to select from 
it the most suitable remedy, that is to say, the 
remedy of which the individual peculiarities coin- 
cide most nearly with those of the case to be 
treated." 

Acting upon this rule Dr. Wurmb has described 
the peculiarities of several groups of drugs and 
pointed out their adaptations to different forms of 
typhoid fever. The first of these groups consists 
of Rhus toxicodendron and Phosphoric acid, the 
similarities and peculiar differences of which are 
finely depicted by him. He remarks first that the 
casss of fever in which these drugs are required 
and were used by him, are not very grave and 
severe forms, — the epidemic could not be called a 
malignant one. " The disturbances in the vascular 
and nervous systems, though often tolerably severe, 
were never excessive, and the tendency to decom- 



RHUS TOXICODENDRON. 



141 



position of the organic substance, although it existed 
and was developed, was not very striking. The 
appropriate remedies, consequently, were such as, 
in large doses, in healthy subjects, act powerfully, 
it is true, on the life of blood and nerve ; pervert 
the latter, but do not completely suspend it; cause 
disturbances in the vital chemistry but do not 
entirely supersede it ! " 

Rhus toxicodendron and Phosphoric acid, being 
drugs which act in an equal degree upon both the 
vital force and the organic substance, and which 
act powerfully but not destructively, were suitable 
to an epidemic of this character. 

Now, the distinction between these two drugs 
may in a word be stated as follows : Rhus is char- 
acterized by symptoms of erethism, excitement, 
orgasm ; Phosphoric acid by symptoms of torpor, 
collapse, sluggishness. This is the proposition 
which, in so far as Rhus is concerned, we proceed 
to elaborate in the words of Dr. Wurmb. 

"Indications for Rhus. The patients are gene- 
rally strongly built persons who have hitherto been 
healthy; the typhoid for the most part comes on sud- 
denly, runs a rapid course, and reaches in the course 
of a few days a high degree of development. At 
the same time with the disturbances in the vascular 
system, there is felt a strong sensation of illness, 
which advances at a more rapid rate than the other 
symptoms do ; for example, the actual debility is not 
so great as the sensation of debility, inasmuch as 
tolerably rapid and forcible motions are still capable 



142 RHUS TOXICODENDRON. 

of being made. (N. B. — During convalescence, the 
contrary condition obtains ; the patients take them- 
selves to be stronger than they really are.) 

" Soon, however, the forces fail ; movements 
become difficult and feeble and the patients are 
constrained to lie quietly in bed, in one place. 
They complain of aching in the limbs and, some- 
times, of violent pain in some joint or other, as 
in rheumatism. 

"These disturbances in the general condition 
do not long continue alone ; there are soon asso- 
ciated with them irregularities in the vascular sys- 
tem, viz. : in the beginning, gentle, fugitive chills 
and heat, but especially heat of the head ; at a 
later period the heat predominates, and at last it 
becomes continuous and is very violent ; there is 
tendency to rush of blood to the head ; roaring 
pains in the head ; the temperature is elevated ; the 
face is burning hot to the touch ; the eyes shine 
and are moderately injected ; the cheeks, lips and 
tongue are of a deep red color ; the thirst is very 
great; the pulse 110-112 in a minute. Even at 
the very beginning of the vascular excitement 
haemorrhages occur, especially from the nose, and 
in women, from the genitals. The former almost 
always afford relief, the latter, which are generally 
mistaken for the menstrual flow, last but a few 
hours, or, at the most a day, and produce no 
change in the condition of the patient. 

" The symptoms of a change in the composi- 
tion of the blood (of a sort of decomposition, 



RHUS TOXICODENDRON. 



H3 



being" the first evidence of action upon the organic 
substance) appear in a moderate degree only and 
somewhat later. There appear upon the skin small 
ecchymoses ; the expectoration has a bloody tinge ; 
the stools rarely contain blood. 

" The nervous functions are always powerfully 
affected ; they are oppressed and restricted. The 
organs of sense are, in the beginning, in a condi- 
tion of over-excitability. There is a great sensi- 
bility to light, noise, etc. 

" At a later period the opposite condition 
obtains ; the patients become insensible to external 
influences, complain of nothing whatever, and lie 
in a condition of atony. 

" The sensorium is oppressed and ratiocination 
is difficult even in the very beginning of the dis- 
ease. The patients are aware of this fact, but 
endeavor to prevent its being observed ; and to 
this end, when a question is put to them, they 
evidently gather themselves up and reply hastily, 
but correctly ; at a later period, when their imag- 
ination has become too lively, they cannot quite 
succeed in this, and hence their answers are in 
part correct and in part incoherent; finally the inco- 
herence increases ; the patients murmur and keep 
talking to themselves, or they are disquieted by 
very lively phantasies of the most various sorts, 
especially at night. Sleep for the most part fails 
entirely; or when for a moment it visits the patient, 
there comes in its train a host of disquieting and 
burthcnsome dreams. * * * * * 



144 



RHUS TOXICODENDRON. 



" The abnormal condition of the vascular system 
is distinctly reflected upon the external skin. This 
is at first reddened, dry and hot ; spots appear, 
resembling rubeola or measles, upon the thorax 
and abdomen ; if the vascular excitement has sub- 
sided, copious sweats occur and along with them, 
almost always, a miliary eruption. 

"The mucous membranes are always involved. 
The tongue is more or less coated, becomes 
rough, dry, cracked and woody ; the lips and teeth 
are sometimes covered with brown sordes ; the 
taste is gone. The condition of the gastric and 
intestinal mucous membrane is such as to produce 
want of appetite ; aversion to food ; nausea, retch- 
ing, vomiting. Gases are developed in the intesti- 
nal canal, which distend the abdomen. The 
abdomen becomes sensitive to external pressure 
under the margins of the left ribs and in the right 
iliac region. The stools are at first scanty and 
infrequent, indeed there may be none for several 
days ; generally, however, they soon become fluid 
and occur three or four times daily without tenes- 
mus or other discomforts ; and at a later period, 
when they are still more frequent, they pass invol- 
untarily. They consist of serum and of a greenish- 
brown substance, which, at a later period of the 
disease, is mixed with white flocculi. 

"Resulting from the affection of the mucous 
membrane of the air passages, there is a sensation 
of dryness in the trachea ; the somewhat accelerated 
respiration is, at first, somewhat louder, sharper, the 



RHUS TOXICODENDRON. 145 

expiration audible ; at a later period, mucous rales 
set in, or large crepitation. The cough, which at 
first is moderate and dry, becomes gradually more 
violent and looser in sound, but accompanied by 
only a very little tenacious sputa, now and then 
streaked with blood. 

" The parenchyma of the lungs is congested 
with blood, especially in the lower lobes, and 
pneumonic infiltrations often form there, which 
explain the following symptoms, not infrequent in 
typhoid : Constriction of the chest ; short, anxious 
respiration ; sticking pains in the sides, etc. The 
spleen is almost always enlarged. The urine is 
scanty ; it is deficient in chloride of sodium and in 
urea; rich in sulphates, phosphates and other salts 
which are always abundant in diseases which are 
characterized by a tendency to decomposition of 
the blood. The urine, moreover, is turbid, looks 
like whey, deposits an abundant white sediment, 
and shows, by the albumen which it contains, the 
hypersemic condition of the kidneys. * * * 
" The condition above described may last many 
days. The patient may pass from it into a state 
of health, or into a still higher grade of erethism, 
or into the opposite condition of torpor. * * 
" In the former case, viz., that of a return to 
health, the febrile movements slacken ; sleep again 
visits the patient ; the sensorial phenomena become 
less abnormal ; the patient gets his appetite again, 
and congratulates himself on his fine condition ; the 

diarrhoea and tympanitis may last a few days longer 
1 1 



I4 6 RHUS TOXICODENDRON. 

than the other symptoms, but they then vanish 
and there remain only a moderate degree of weak- 
ness and emaciation, and paleness of the skin. 
***** * 
" In the event, however, of the development of 
the disease to a still higher grade of erethism, we 
have not generally long to wait. In this case it 
is probable that Arsenicum will be our remedy." 

For Arsenicum, as we shall see by and by, 
affects both the vascular and nervous life on the 
one hand, and the blood composition on the other 
hand; it acts, with almost equal energy, on the 
vital forces and on the organic substance. It is, 
hence, appropriate for such a form of fever as that 
described as requiring Rhus. But Arsenicum acts 
with greater energy, with a wider swing and deeper 
penetration than Rhus. It perverts more thoroughly, 
excites more profoundly the vital functions ; it alters 
more extensively and more completely the blood 
and the organic substance than Rhus does. It is, 
therefore, appropriate for more malignant epidemics 
of fever, for more severe cases of the same form 
of fever than Rhus. 

Thus, as regards the erethistic form of typhoid 
fever, a group is formed consisting of Rhus and 
Arsenic, which, instead of being contrasted as Rhus 
and Phosphoric acid were, are analogous and allied. 
They stand related to each other as less and greater, 
Rhus being the less and Arsenic the greater. 

But if the fever change from the erethistic into 
the torpid form, then Phosphoric acid will probably 



RHUS TOXICODENDRON. 



147 



be required as the correlative of Rhus; or if the 
torpor be extreme, Carbo vegetabilis may be 
required, as the correlative of Arsenic. 

To show, now, the applicability of Rhus toxico- 
dendron to the form of fever which has been 
described, Wurmb proceeds to say : 

" If we hold up beside this picture of the 
disease, the picture of the action of Rhus toxico- 
dendron, so striking is the similarity that it will 
not be easy to mistake it. They agree not alone 
in this, that in both, the same symptoms and 
groups of symptoms appear, but also that they 
have in both the same significance. The similarity 
is therefore not simply apparent, it is real. For, 
as in typhus, the blood-life is especially affected, 
the same is the case in the Rhus disease. As in 
typhus, by reason of the changes in the blood, a 
violent excitement occurs in the vascular system, 
the same is the case with Rhus ; as in typhus, the 
sensorial functions are depressed, and in conse- 
quence of this depression the imagination is 
unchained and set loose to work its fancy, and the 
representations of the general perceptive faculty no 
longer correspond to the phenomena upon which 
this faculty is exercised ; as in typhus, the mucous 
membranes, especially those of the intestinal canal, 
in which deposits and irritations never fail, are 
especially involved ; in short, just as typhus, in 
spite of the erethism which is present, is an 
adynamic, morbid process, in the exact sense of 
the word, and tends to produce, even in the begin- 



^8 RHUS TOXICODENDRON. 

ning, a decomposition of the blood and an exhaustion 
of the vital force ; the very same is true in all 
these respects of the morbid affection produced in 
the healthy subject by Rhus toxicodendron. 

Having thus treated very fully the subject of 
Rhus in fevers, I should, perhaps, in strict defer- 
ence to the unity of subject, proceed to treat of 
Rhus in relation to other diseased conditions. But 
lectures of this kind are worth nothing if they are 
not practical. I cannot hope, in the short time 
accorded me, to treat of all the drugs in the 
materia medica, nor to treat fully of many, if 
indeed of any. The most I can hope for is to 
show you how to study drugs in a practical way, 
and how to reason upon and to apply the knowl- 
edge gained by study and observation. Now, the 
essence of the study of the materia medica is 
comparison, — the comparative study of one drug 
beside another drug, with a view of noting their 
resemblances and differences ; the successive study 
of each drug of a group, in comparison with the 
picture of some disease to which you suppose the 
group, or some member of it, to be applicable as 
a remedy. 

We have studied in detail a certain form -of 
typhoid fever, and I have stated that the remedies 
most similar to that form and degree of intensity 
are Rhus toxicodendron and Phosphoric acid. I 
have stated the special similarity of Rhus, but the 
practical question for you is to know also what 
cases require Phosphoric acid, that you may be in 



RHUS TOXICODENDRON. 



149 



a position when you meet this form of fever to 
discriminate between the indications for these two 
remedies respectively, and may be able to give 
each in just the case which requires it. 

I shall help you then, I think, if now, while 
the subject is fresh in your minds, I introduce into 
my lecture on Rhus an episode upon Phosphoric 
acid, — the correlative of Rhus toxicodendron, — and 
in this, as before, I shall follow my excellent friend 
and teacher; Dr. Wurmb. 

Indications for Phosphoric acid in typhoid: 

"The morbid condition corresponding to Phos- 
phoric acid agrees in essential points with that 
which requires Rhus. In both we find the same 
relations to the blood and nerve life ; the same 
tendency to decomposition of the blood and to a 
waste of the forces ; the same changes in the 
mucous membranes generally, but especially in that 
of the intestinal canal, etc." 

The difference between them consists in this, 
that in the Rhus affection there is more prominent 
an erethism of one portion of the vital phenomena 
and a depression of another portion, a one-sided 
excitement and a one-sided depression, whereas in 
the Phosphoric acid affection there is a general 
and simultaneous depression, letting down, atony 
of the entire series of vital phenomena. Whereas 
in the Rhus affection, we see excitement and over- 
activity in the functions of vegetable life, and 
simultaneous depression in the functions of animal 
life ; we see in the Phosphoric acid affection simul- 



I5O . RHUS TOXICODENDRON. 

taneous and immediate depression in the functions 
of both of these departments of the patient's organ- 
ism. Generally this depression appears in the very- 
beginning of the sickness, though not always, for 
sometimes partial phenomena of excitement usher 
in the disease ; these, however, are of short dura- 
tion and very moderate intensity ; and after their 
disappearance the torpid character of the attack is 
all the more distinctly perceptible. 

Cases of this kind are most frequently observed 
in debilitated subjects who have passed the prime 
of life ; they require a longer time for their devel- 
opment into a distinct form of disease. Thus, for 
example, there are often noticed loss of appetite, 
feeling of illness, and a host of other preliminary 
symptoms which indicate an impending illness but 
give no clue to its particular form and character, — 
these, for weeks together, before the peculiar and 
really important symptoms set in which assure the 
diagnosis. When these latter have at last made 
their appearance we observe the following : 

The sensations of illness and prostration reach 
speedily a very high grade, and pari passu with 
these sensations goes an actual want of power, and 
hence the patients even in the very beginning of 
the malady are content to lie quiet, because every 
movement is a heavy tax upon them. The dis- 
turbances in the vascular system do not advance 
in the same ratio, but lag behind; the pulse is 
often accelerated, it is true, though sometimes it is 
not, and in the former case it is generally feeble 



I 

RHUS TOXICODENDRON. 151 

and small. The temperature is but seldom ele- 
vated ; indeed it sometimes sinks below the normal 
grade. If it is increased the increase is confined 
to isolated parts of the body, especially the head, 
while other parts, the extremities in particular, are 
cold to the touch ; the patients hence are pale, or 
have only sometimes a flush of redness. Haemor- 
rhages, as for example from the nose, are much 
more frequent, but they afford no relief ; nay, they 
commonly aggravate the condition of the patient. 
Ecchymoses are likewise common occurrences, and 
these are particularly apt to occur on the spots on 
which the patients lie, — livid spots, which at a later 
period become sloughing bed-sores. 

The patients, for the most part, lie in a con- 
stant slumber, which is apt to pass into a higher 
grade of stupor ; the expression of face is stupid ; 
the sensorium is oppressed, the delirium, if it exist, 
is never lively or active; it takes only the form of 
an unintelligible murmuring. If the patient be 
aroused from this stupor it takes him a long time 
to come to his senses, he looks around him in a 
kind of dull, stupid wonder, answers slowly, even 
though it be correctly, and soon sinks back again 
into his former apathetic condition. 

The special senses become dull, but especially 
the sense of hearing. The patients are influenced 
and affected by nothing. They complain of noth- 
ing but weakness and confusion of the head. 

The skin soon loses its plumpness, takes on a 
shriveled aspect and is loose and wrinkled ; the 



RHUS TOXICODENDRON. 



cheeks become sunken ; the nose pointed ; the skin 
is constantly clammy, moist, and even often covered 
with a copious sweat and with countless miliary 
vesicles. 

The affection of the mucous membrane is evi- 
denced chiefly by increased secretions ; the tongue 
is moist but pale. 

In the thorax are heard large crepitation and 
rhonchus. Cough is rare, because the need to 
expel the mucus is not felt by the patient. A sim- 
ilar condition obtains in the mucous membrane of 
the stomach and intestines ; the stools are copious, 
often involuntary and passed unconsciously. They 
are very liquid, contain but little sediment and 
show sometimes traces of blood. 

The pneumonic infiltration is not rare, but it is 
by no means so frequent as the hypostatic conges- 
tion. 

Enlargement of the spleen never fails; the 
diarrhoea, even when it is ever so copious, has no 
influence upon this symptom. 

The urine contains many protein compounds, 
much albumen, but few salts. 

This state of things may pass off into health or 
may merge in a still higher grade of torpor. If 
the former change takes place, the recovery is a 
slow one and relapses commonly take place even 
when the improvement has been for some time in 
process. 

If, however, the latter change takes place, and the 
state of things above described gives place to a 



RHUS TOXICODENDRON. 



153 



still more complete and absolute torpor, then it is 
probable that Carbo vegetabilis will be the remedy 
indicated. For, just as we have seen that in the 
erethistic form of typhoid fever, Rhus and Arsenic 
bear to each other the relation of less and greater, 
so in - the torpid form of the disease do Phosphoric 
acid and Carbo vegetabilis bear to each other the 
same relation of less and greater. And the proving 
of Carbo vegetabilis, I may here remark, is the very 
type and representative of an asthenic and torpid 
pathogenesis. 

These remarks will suffice to give an idea of 
the application of Rhus in fevers. They have 
included no name except that of typhoid fever — 
but surely, I need not at this hour remind you 
that, no matter how different may be the names 
that are applied to morbid conditions, if the condi- 
tions be similar the remedy may be the same. 
Now, it often happens that in the course of the 
exanthematous fevers, measles and scarlatina, a 
similar train of symptoms to those already described 
makes its appearance and calls for Rhus. Espe- 
cially is this the case in scarlatina, a disease in 
which the value of Rhus is not well understood by 
the profession. It will be more ably expounded 
than I can do it by Dr. Wells in some of the 
forthcoming numbers of the "American Homoe- 
opathic Review." 

The indication for Rhus in scarlatina is still 
stronger if, in addition to symptoms already de- 
tailed, there be an cedematous condition of the 



154 



RHUS TOXICODENDRON. 



fauces, soft palate and uvula, with vesicles upon 
these parts and a singularly annoying itching, 
smarting and burning. Independently of scarlatina, 
epidemics of influenza often occur presenting this 
cedematous condition of the soft parts of the fauces 
and pharynx, and even threatening cedema glottidis. 
The curtain of the palate is puffed and pink ; the 
uvula is elongated, puffed, translucent, and the 'end 
is often nearly spherical, looking like a great drop 
of fluid or jelly just ready to fall off. Vesicles stud 
the pharynx. The rawness and roughness of 
pharynx and larynx are almost intolerable. Such 
an influenza is generally attended by symptoms of 
great debility ; in any case, it finds a suitable and 
prompt remedy in Rhus, as I have often expe- 
rienced. 

In paralysis, especially of the lower extremities, 
Rhus is an important remedy. But the paralysis 
for which it is appropriate is not that 'form which 
results from a lesion of the spinal cord. It is 
rather of the motor than of the sensitive nerves ; 
for I believe sensation is not much impaired. In 
the form known as rheumatic paralysis, where 
the paralysis supervenes upon rheumatism, Rhus 
is especially called for. So, likewise, as would be 
expected, in cases resulting from undue exposure to 
cold and dampness, especially exposure of the back 
or limbs. 

This explains the value of Rhus in a form of 
paralysis not rare in very young children. It 
affects only the lower extremities, and comes, I am 



RHUS TOXICODENDRON. 



155 



persuaded, though it is difficult to trace these 
things, from nurses allowing children to sit down 
on cold stone steps. If these paralyses last long 
they produce deformity by arrest of development. 
They are, in general, easily cured with Rhus and 
an occasional dose of Sulphur. 

As regards the application of Rhus in rheuma- 
tism, I believe enough has been said of the 
characteristic action of Rhus to solve all doubts on 
this subject. Just as Rhus produces in the mucous 
membranes an inflammation which is not phleg- 
monous only inasmuch as it does not go on to 
suppuration, so does it act on the serous membranes 
of the joints and muscles. The serous secretions 
are increased and cedematous swellings are produced. 
The local manifestations, therefore, resemble those 
of rheumatism. 

The fever has been described, ^he general 
condition must be of an erethistic typhoid charac- 
ter. The joints are swollen, cedematous, the pains 
worse during repose and stimulating the patient to 
constant exertion and motion of the part, both day 
and night (restlessness only at night requires Caus- 
ticum). 

The condyles and salient points of bone are 
sore. The pains and soreness are relieved by 
warmth. Perspiration is copious and does not 
relieve. 

The skin is the part most obviously affected by 
Rhus. It produces a most remarkable imitation of 
vesicular erysipelas, and is our most valued remedy 



RHUS TOXICODENDRON. 



in this affection. Any one who has seen a case of 
Rhus-poisoning (for which, by the way, the best 
remedy is Sepia) will recognize the similarity to 
eczema, for which, in its various forms, Rhus is a 
most valuable remedy. But its grand role is in 
the treatment of the pustular form, — impetigo <scze- 
matodes or eczema impetiginodes, or baker's itch, 
as it is called. 



COLCHICUM. 



HAVING now studied the properties and uses 
of Bryonia, Aconite and Rhus, remedies 
which, in addition to their applicability in fevers 
and various other affections, are eminently adapted 
to the treatment of the general class of maladies 
grouped under the name of rheumatism, it seems 
to me most fitting to study now certain other drugs 
which are eminently anti-rheumatics, before pro- 
ceeding to other groups of which the characteristic 
symptoms indicate a different variety of action upon 
different organs and tissues. These drugs are 
Colchicum, Ledum, Rhododendron, Kalmia, and 
Spigelia. 

The autumn crocus, or meadow-saffron, is a 
beautiful flower, found in most parts of temperate 
Europe, and especially abundant and beautiful near 
the site of the ancient Alba Longa, not far from 
Rome. The parts used are the root and the 
seeds, and various opinions have been expressed 
by different authors respecting the relative activity 
of these portions of the plant. The majority of 
the provings made by homceopathists were made 



158 



COLCHICUM. 



with a tincture of the freshly gathered root. Col- 
chicum was well known to the ancients, as indeed 
its name implies (from the island Colchos, where 
it abounded), and very little has been added, even 
in our day, to the knowledge which the ancients 
possessed of its properties and uses. It was de- 
scribed by them as a violent emeto-cathartic, and 
on that account a dangerous remedy ; as, however, 
a specific remedy for gout and rheumatism, in 
which it gave magical relief. They considered its 
frequent and continued use in gout to be injurious, 
because of its action on the stomach and bowels, 
and Alexander of Tralles, in the fifth century, 
says that although it does speedily relieve the 
pain and soreness of an attack of gout, it never- 
theless favors the frequent recurrence of these 
attacks, — an opinion which is repeated by Mr. 
Barwell, the most recent authority on " Diseases 
of the Joints." (London, i860.) 

In general, the effects ascribed to Colchicum 
are the following : in large doses it produces loss 
of muscular power, slow breathing, and slow and 
feeble pulse. The sensorium is but little disturbed. 

Upon the digestive organs it acts with great 
energy, increasing and altering the secretion from 
some or all of their mucous surfaces. Sometimes 
profuse salivation results. More frequently, profuse 
secretion of urine. But most frequently of all, 
nausea, eructations and copious vomiting of mucus 
and bile with frequent and abundant alvine evacu- 
ations, consisting of watery matters with white, 



COLCHICUM. 



!59 



skinny flocculi, or of yellowish and bloody matter. 
There is much tenesmus. The flatulent distention 
of the abdomen is sometimes enormous ; when 
this is the case the stools are not so frequent nor 
so copious. Perfect loathing of food, — a symptom 
which led Dr. Hawley to give Colchicum success- 
fully in an intermittent. 

This action upon the intestines is observed 
not merely when the Colchicum is taken into 
the stomach, but also when it is injected into a 
vein or rubbed upon the external skin of the 
abdomen. 

In addition to the above symptoms, the nervous 
system has been observed to be affected as fol- 
lows : " Numbness of the hands and feet, with 
prickling as if they were asleep ; painful flexure 
of the joints ; pain in the shoulder and hip joints 
and in all the bones, with difficulty of moving the 
head and tongue." (Henderson.) The general loss 
of power is as remarkable as the fact that even 
in cases cf extreme poisoning, the mind remains 
clear. Death probably results from paralysis of 
the heart. 

Colchicum is one of many examples of the 
great difference in both the degree and kind of 
action which drugs exert on the organism of differ- 
ent animals. In v<ery small doses it is fatal to 
dogs, producing violent emeto-cathartic action. 
Hence the French call it tne-chicn. In cows it 
produces scanty urine, great distention of the abdo- 
men, but no profuse diarrhcea. In rabbits it pro- 



i6o 



COLCHICUM. 



duces enuresis, but hardly any serious symptoms. 
A frog will take with impunity a dose that would 
speedily kill a large dog. This example shows the 
fallacy of deducing from experiments on animals 
rules for the use of drugs in diseases of the human 
organism. 

The following summary of the action of Col- 
chicum upon the healthy human subject is derived 
from Stapf's proving, in the "Archives of the 
Homoeopathic Art," vol. vi., and from records of 
provings which are abundant in medical literature, 
and of which an excellent summary is given by 
Hartlaub, in the " Homceopathische Vierteljahr- 
schrift," vol. viii. The provings are still very 
imperfect. 

Sphere of Action. Taking a general view of 
the action of Colchicum, we find it to be exerted 
chiefly on the bones (or periosteum), on the syno- 
vial membranes of the joints, on the urinary and 
digestive organs, and upon that part of the nervous 
system which presides over the function of volun- 
tary motion. It acts also somewhat upon the 
respiratory organs. It therefore acts with about 
equal scope upon both the vital force and the 
organic substance. 

It is a remarkable fact that although the action 
of Colchicum upon the regions arid tissues already 
named is very energetic, the drug being a poison 
of a speedy and fatal action, even in moderate 
doses, yet upon the sensorium it produces almost 
no effect, the mind remaining clear to the last. 



COLCHICUM. 



161 



Sensations. The sensations which Colchicum 
produces are a shuddering and creeping in isolated 
parts of the body, such as are wont to be felt on 
getting cold from change of weather. Also, a 
tearing, tensive pain in small portions of the body 
at a time, and quickly changing its location from 
one part to another. Also, sudden tearing shocks 
or jerkings throughout one entire half of the body. 
Sometimes sticking or jerking drawings, or weak 
drawing and tearing in various muscles. The most 
distressing pains are the sticking shocks or jerks, 
which are felt deep in the soft parts, and, as it 
were, upon the periosteum. 

Aggravation. They are worse at night, and 
deprive the patient of sleep. 

Concomitants. They are attended by a symptom 
which is characteristic of Colchicum, viz., a feeling 
of muscular weakness or paralysis, and this feeling 
it is which interferes with the patient's locomotion. 
Finally, there are sticking pains in the joints. 

The weakness is very great; the whole body 
is sore and sensitive ; there is a sensation of trem- 
bling felt throughout the body; all the muscles of 
voluntary motion, but especially those of the arms 
and legs, are paralyzed. The knees strike together, 
and the patient can hardly walk. 

Peculiarities. The pains are much aggravated 
at night, becoming intolerable, and they are aggra- 
vated also by any mental exertion or by emotion. 
There is great sleepiness during the day, with 

indisposition to exertion of any kind, and confusion 
12 



l62 



COLCHICUM. 



and dullness of the head. At night, however, the 
sleep is disturbed or driven away by pains. If he 
sleep, the patient is wakened by frightful dreams. 

As regards fever, we observe chilliness through 
the limbs or down the back, sometimes dry heat, 
especially at night. Sweat copious and sour. But 
in general the febrile symptoms are few and mod- 
erate in intensity. 

The sensorium is no further affected than that 
it partakes, in some degree, of the general depressed 
condition. The memory is weakened, and the ideas 
are not so clear as is customary with the patient. 

Coming now to the special analysis, we find : 

Head. Pressing pains, above, in small spots or 
very severely in the substance of the cerebellum, 
and occurring on the slightest intellectual exertion; 
a pressing heaviness in the cerebellum, especially 
on moving or stooping forward. 

Tearing pains, sometimes in one-half of the 
head and sometimes in the occiput (the pains, as 
already stated, wander), sometimes in the temples, 
sometimes in the pericranium. A pressing tearing 
in the occiput, finally a very painful, drawing tear- 
ing in one-half of the head, beginning at the ball 
of the eye and extending to the occiput. (This 
reminds us of Spigelia, which has a similar symp- 
tom on the left side, and of Silicea and Belladonna 
on the right side.) 

Character. To recapitulate, the pains are tear- 
ing, drawing and pressing. They are most frequent 
in the occiput, and are often semi-lateral. The 



COLCHICUM. 163 

characteristic symptom is the severe pressing pain 
deep in the substance of the cerebellum, occurring 
on the slightest intellectual exertion. 

Some remarkable symptoms are recorded of the 
Eyes. Drawing, digging pains deep in the orbit, 
resembling those of sclerotitis. Pressure and biting 
in the canthi with moderate lachrymation. Violent 
sharp tearing pains in the globe of the eye and 
around the orbit. 

Face. The expression of the face is that of a 
chronic patient There are tearing and tensive 
pains in the facial muscles, moving from one loca- 
tion to another. Likewise drawing in the bones of 
the face and nose, a sensation as if they were 
being rent asunder. 

The teeth are very sensitive when pressed 
together, as in biting. Tearing in the jaws and 
gums; the teeth feel too long. The pains in the 
teeth are aggravated when, immediately after taking 
something warm into the mouth, the patient takes 
something cold. 

In the tongue, tearing, burning and sticking. 
Also a loss of sensibility in the tongue, the first 
symptom we encounter of the Colchicum paralysis. 

In the throat, a tickling as if a coryza were 
setting in, which induces the patient to cough and 
to clear the throat. The mucus is thin and green- 
ish and comes sometimes involuntarily into the 
mouth. Externally, in the cervical muscles, some- 
times a pressing pain, sometimes a tension, felt 
even when swallowing. The throat is dry, and yet 



COLCHICUM. 

there is a flow of watery saliva, accompanied by 
nausea, fullness and discomfort in the abdomen. 

In the digestive apparatus, we find considerable 
thirst, but absence of appetite. Frequent and 
copious eructations of tasteless gas. Nausea with 
great restlessness and, on assuming the upright 
posture, a qualmishness in the stomach and inclina- 
tion to vomit. Violent retching, followed by copious 
and forcible vomiting of food and then of bile. If 
the patient lie perfectly still, the disposition to vomit 
is less urgent. Every motion renews it. (This is 
characteristic also of Tabacum and Veratrum.) 

The pit of the stomach becomes very sensitive 
to touch and pressure. Sometimes there is a 
burning sensation in the stomach, more frequently 
a feeling of icy coldness, accompanied by great 
pain and debility. (I cannot forbear remarking 
here the similarity of this symptom to one form of 
" retrocessed gout") 

Pressing, tearing, cutting and stitching pains in 
the abdomen. Great distention of the abdomen 
with gas, feeling as though the patient had eaten 
too much. This condition affects particularly the 
upper part, under the short ribs. 

Tearing and burning at the orifice of the rec- 
tum are frequent symptoms, and prolapsus ani has 
been observed. 

The symptoms of the stool present two charac- 
ters depending on the magnitude of the dose and 
the period that has elapsed since the drug was 
taken, and also upon the extent to which other 



COLCHICUM. 



emunctories are affected. For, if there be copious 
salivation and copious secretion of urine, the stool 
will be scanty and attended by tenesmus, and vice 
versa. Thus, then, if the intestinal canal be the 
seat of the most powerful action of Colchicum, and 
if the symptoms be observed early, we have copious, 
frequent watery or bilious stools, often without pain, 
sometimes accompanied by cutting colic. 

On the other hand, we observe scanty and diffi- 
cult evacuation of a stool consisting of bloody mucus 
and shreds, with pains in the anus, great straining 
and a spasmodic action of the sphincter, and constant 
ineffectual effort to pass faeces. (Colchicum, taking 
these symptoms in connection with its rheumatic 
and semi-typhoid symptoms, will be, as it has 
proved itself, a valuable remedy in many cases of 
autumnal dysentery.) 

Upon the urinary organs we have the same 
twofold action. The secretion is sometimes very 
copious, watery and frequent. But, generally, in 
the human subject the secretion of urine is dimin- 
ished ; the urine is dark, turbid, and its evacuation 
is attended and followed by tenesmus of the blad- 
der, and a burning pain in the urethra as if the 
urine were very warm. 

Respiration. On the respiratory organs the 
action of Colchicum is a subject of dispute among 
old-school authorities. We find it produces a long- 
lasting coryza, which is never watery, but is char- 
acterized by secretion of abundant tenacious mucus, 
tickling in the trachea and a little cough. 



COLCHICUM. 



It produces frequent oppression of the chest, 
dyspnoea, a tensive feeling in the chest, sometimes 
high in the chest, and sometimes low down. These 
symptoms point to the efficacy of Colchicum in 
some forms of asthma, a subject on which old- 
school doctors differ. Homoeopathicians have often 
used it very successfully in asthma. 

In the posterior part of the thorax, dull stitches, 
as much in the back as in the ribs. It is charac- 
teristic of these stitches that they are chiefly felt 
during expiration and not during inspiration. 

Back. In the back we note the various kinds 
of drawing tensive and stitching pains remarked 
elsewhere. They occur or are much aggravated on 
motion. On the sacrum, a spot as large as one's 
hand which feels sore, as if ulcerated, and is very 
sensitive to the touch. 

Extremities. In the extremities, tearing pains 
in both muscles and joints, stitching pain in the 
joints. The pains wander from part to part. 
They are aggravated by motion and at night. 
They feel as if in the periosteum. Conjoined with 
the pains is a very distressing paralytic feeling, 
together with an actual loss of muscular power 
approximating paralysis. The action of Colchicum 
is more marked on the small joints than on the 
large. 

Application. Colchicum was regarded by the 
ancient Greek and Arabian physicians as a specific 
for gout, but a somewhat dangerous remedy. It 
fell into disuse until Stoerck, in Vienna, in the 



COLCHICUM. 



167 



eighteenth century, called attention to it. He 
proved it in a rude way, and vaunted it as a rem- 
edy for gout, rheumatism, asthma and dropsies. 
Its efficacy in asthma, affirmed by many physi- 
cians, has been denied by others, except the asthma 
depend on hydro-thorax or hydro-pericardium, in 
which cases it is admitted Colchicum may relieve 
by removing the dropsical effusion. Stoerck's recom- 
mendation of Colchicum as a remedy in gout did 
not attract much attention until it was found that 
Colchicum was the chief ingredient of several 
famous nostrums for gout, as the Eau medicinale 
of Husson and the pills of Lartigue and others. 
At the present day its value is recognized and we 
all have opportunities to see the mischief inflicted 
by its improper uses. 

Alexander of Tralles, in the fifth century, and 
Mr. Barwell, in i860, affirm that it predisposes to 
relapses. In cases in which it does so it cannot 
be the true remedy. 

It has been a subject of discussion whether it 
acts specifically in gout or only by virtue of its 
hydragogue properties. The question is settled by 
the fact that other hydragogues do not relieve gout 
as Colchicum does. Also by the fact which I have 
myself seen, and which is attested by many physi- 
cians, that its action is manifest in relieving the 
gout only or chiefly when means are taken to pre- 
vent its action on the bowels, as by combining 
Opium with it, or by copious draughts of rice- 
water. 



i68 



COLCHICUM. 



Having alluded to injurious effects upon the use 
of Colchicum, I will quote a few sentences from 
"Barwell on the Joints," p. 176: 

"Colchicum is a remedy whose value is un- 
doubted, but its influences for evil are almost as 
certain; it is more powerful in gout than in rheu- 
matism. It has a power in checking the pains, 
etc., of both rheumatic and gouty diseases, but it 
also has an effect in procuring relapses. Persons 
who have been treated with this remedy suffer 
from the return of the disease more rapidly than 
those treated by some other medicine." 

Dr. Tod says the relapses are apt to assume an 
asthenic character, p. .224. 

" Colchicum is a two-edged sword of consider- 
able sharpness; there is no doubt of its great 
power in checking gouty and even rheumatic -pains; 
but it is very questionable whether it does so in a 
beneficial manner. The late Dr. Tod believed that 
it changes the common acute form of gout into an 
asthenic condition which is less easy of manage- 
ment ; and there is great reason to believe this 
idea correct. Any practical opinion which is the 
result of experience, not of mere a priori reason- 
ing, deserves great attention ; and we may be sure 
of this fact, that whatever the modus operandi of 
the drug may be, it hastens relapses, renders each 
one less amenable to treatment and requiring larger 
doses of the medicine (if treated with Colchicum) 
than its predecessors. Whether the remedy act 
simply as a purgative, or as stimulating the liver, 



COLCHICUM. 



169 



or as causing a larger excretion of lithic acid, is 
not certain ; but its use is permissible only when 
the constitution is vigorous, and it should not be 
given except when other means of procuring ease 
have failed." 

I fancy that every one who has seen cases of 
gout or rheumatism treated by Colchicum will 
indorse the statements of Mr. Barwell and Dr. 
Tod. Yet they are wrong in banishing Colchicum 
from the list of remedies to be employed at the 
beginning of treatment. It has its place in the 
treatment of gout and rheumatism, and if properly 
employed in appropriate cases will do good, and 
good only. Allopathic authors are almost unani- 
mous in recommending Colchicum as Mr. Barwell 
does, as suitable only in persons of vigorous con- 
stitution, and in whom the manifestations of the 
disease are acute and active or only approaching 
the sub-acute, and they caution us against using it 
in feeble cases and in asthenic conditions. Why ? 
Because, as they tell us, its tendency is to produce 
an asthenic condition, and none but vigorous 
patients can bear it. Others would be reduced too 
low. Here we have the old idea of antagonism 
between the action of the drug and that of the 
morbid organism, the latter not being regarded 
(as I think it should be) as engaged in a struggle 
against the morbific influence, of which struggle the 
symptoms are the phenomena, and in which struggle 
the drug should act in co-operation with the organ- 
ism and in the same direction as the symptoms. 



COLCHICUM. 



If we look at the symptoms produced by Col- 
chicum, we find the rheumatic or gouty symptoms 
characterized by a debility, a paralytic weakness, 
very suggestive of an asthenic type of disease. 
The fact that Dr. Tod and Mr. Barwell have 
observed the tendency of Colchicum to turn the 
active into the asthenic form of gout, furnishes 
additional evidence of this mode of action of Col- 
chicum. Now, it is in precisely this form of 
asthenic sub-acute disease that Colchicum is truly 
indicated and does real service. But, what of the 
danger of reducing the patient? None whatever 
provided we give doses so small as not to produce 
the physiological effects, but only the specific 
effects, which are known to be produced when the 
symptoms disappear. These doses, however, must 
be very small, and, noted as homceopathicians are 
for giving small doses, many of that school err in 
these cases in giving doses too large. I do not 
think it safe to give, in a well-marked Colchicum 
case, a larger dose than the 15th potency. 

Dr. Wurmb speaks of Colchicum in its relations 
to rheumatism, as follows : 

"This drug stands in close relation to the 
fibrous tissues ; it produces, on the healthy, pains 
which are very similar to those of rheumatism ; it 
excites a condition of irritation which is very closely 
allied to inflammation, — redness, swelling, heat, etc.; 
like rheumatic inflammation, this does not tend to 
suppuration, and it easily and quickly changes its 
location. In the Colchicum fever, as in the rheu- 



COLCHICUM. 



171 



matic, the cold stage predominates, the sweat is 
very copious, etc., the urine and sweat have an 
acid smell and reaction. 

"These features closely resemble those of a 
rheumatic attack. Yet, if we look at the entire 
action of Colchicum, we shall perceive that it cannot 
play an exceedingly important role in the treatment 
of rheumatism. For it produces another series of 
symptoms which would often contra-indicate it in 
rheumatism. For example, the muscular weakness, 
the paralytic symptoms, the diminution of vital 
heat, the capillary congestions, all which symptoms 
indicate a vital atony. 

" Consequently, we should rarely find Colchicum 
indicated in the beginning of rheumatic disease, 
rather only when feeble, debilitated persons have 
suffered from it a long time." 

It appears especially suitable to cases in which 
we perceive, on the one hand, an active excitement 
in the local symptoms, and, on the other, symp- 
toms of torpor in the general condition of the 
patient. 

Colchicum was recommended in 1833 against 
Asiatic cholera in England, and used successfully in 
eight cases. But as Dr. Stille says, " notwithstand- 
ing its homoeopathic appropriateness, it has not 
been used by others." 

In autumnal dysenteries we have already alluded 
to its successful use. 

It has been used as a diuretic and palliates 
dropsies. It may be useful in irritation of the 



172 



COLCHICUM. 



bladder, and has been successfully employed in 
Bright's disease. 

Riickert reports its success in asthma. It quiets 
the heart's action. On the healthy it produces vio- 
lent palpitation. 

Bcenninghausen, whose veterinary practice was 
extensive, lauded Colchicum, as a specific for the 
excessive flatulent distention of the abdomen in 
cows who have been allowed to eat too freely of 
clover. This affection is. very fatal. A single dose 
of Colchicum 200 gives prompt relief. This may 
direct our attention to Colchicum in tympanitis 
after certain kinds of food in the human subject. 

Before leaving the subject of Colchicum, I would 
call attention to the fact that in many cases of 
poisoning by it cataracts have formed before 
death in the eyes of the sufferers. 

Professor Hoppe reports that with Colchicum 
he greatly benefited, though he failed to cure, 
three cases of soft cataract. 



LEDUM PALUSTRE. 



THE Ledum palustre, or marsh ledum, marsh 
tea, Rosmarimum sylvestre, a plant belonging 
to the heath family, is a native of northern 
Europe. It is also found in British America along 
the Canadian lakes. It can hardly be called a 
constituent of the allopathic materia medica ; none 
of the standard works mention it. 

Linnaeus, in his " Flora Laponica," states that 
Ledum has been used by the inhabitants of north- 
ern Europe, especially Sweden, as a popular 
remedy against whooping cough, bilious attacks, 
etc. Odhelius recommends it in lepra, pemphigus 
and other skin diseases. The Swedes used a 
decoction of it to destroy vermin on sheep and 
swine. In Lapland branches of it are placed 
among the grain to keep away mice. It has been 
used in Switzerland to adulterate beer, but its 
rapidly acting intoxicating power was attended by 
the production of intense and obstinate headaches. 
The whole plant is used in medicine. 

Our knowledge of the physiological properties 
of Ledum is derived from the proving by Hahne- 



174 



LEDUM PALUSTRE. 



mann and his scholars, published in the " Materia 
Medica Pura," vol. iv. It is but a very fragmentary 
proving. The Provers' Society of Vienna are now 
engaged in a more extended proving of Ledum. 
The provings published are as yet too incomplete 
to be made the basis of a study. 

In so far as our knowledge of Ledum will 
admit of our making a general analysis of its 
action, it may be said : 

That Ledum acts on the vital force to this 
extent, that it interferes with and retards the capil- 
lary circulation, and particularly in the extremities 
and the external surface of the body. This is 
manifest by the coldness especially of the ends of 
the extremities, which characterizes the fever of 
Ledum and to which the heat of certain parts of 
the body at night form the only exception. 

On the organic substance of the body Ledum 
acts extensively and peculiarly ; witness the effect 
upon the skin, on which it produces eczema, lichen, 
pustular eruptions, pemphigus ; and the action upon 
the small joints of the fingers and toes, in which 
enlargements, nodosities and deposits of inorganic 
matter do unquestionably occur. 

The sphere of action of Ledum in so far as 
this is known to us embraces the sensorium, 
the digestive apparatus, the skin and the fibrous 
and serous tissues of the joints and their appen- 
dages. 

The only periodicity remarked in the symptoms 
is this : that the pains in the joints are all aggra- 



LEDUM PALUSTRE. 



175 



vated at night and by the warmth of the bed; 
and that about midnight this aggravation becomes 
so great as to compel the subject to throw off the 
bed-covers. 

As peculiarities attending the symptoms of 
Ledum, it is noted that the pains generally are 
aggravated by warmth at night, the joint pains 
(but not the others) are aggravated by motion ; 
the itching of the skin attending the eruptions is 
aggravated by the warmth of the bed and is not 
relieved by scratching, until the part affected has 
been scratched raw. 

The pains are in the joints, sticking, tearing or 
throbbing and a kind of paralytic pain. These 
pains in the joints are aggravated by motion, 
while other pains are not. 

Ledum produces, moreover, hard and painful 
nodosities in the joints and then the warmth of 
the bed is intolerable, inasmuch as it causes heat 
and burning in the parts affected. 

In the limbs, as considered apart from the 
joints, a feeling of numbness and torpidity. 

A further peculiarity of Ledum is the general 
coldness and lack of animal heat which attends all 
the symptoms, with the exception of those above 
named. 

Though sleepy and dull by day and in general 
not refreshed by sleep, the provers are sleepless at 
night, with restlessness, tossing, and dreams when 
they doze. On waking, a gentle sweat with itch- 
ing of the whole body. 



LEDUM PALUSTRE. 



The fever consists almost entirely of coldness, 
shivering, here and there a little heat, as of the 
cheeks or forehead while the limbs are very cold, 
and a sour-smelling sweat, especially on the fore- 
head; the sweat is often interspersed with shiverings. 

SPECIAL ANALYSIS. 

As regards the sensorium we find Ledum pro- 
duces a feverish condition, a discontented and 
morose disposition, easily aroused to anger, with 
great intensity of feeling in whatever direction it 
may be aroused. 

Vertigo is felt when walking and standing, even 
when sitting still, but is much more violent when 
stooping, when it is attended by a disposition to 
fall forward or backward ; generally there is a 
constant sensation of unsteadiness and drunkenness 
in the head. This with the following symptoms 
should be remembered in connection with the 
adulteration of beer with Ledum already mentioned. 

The head feels as if it were much affected and 
the brain is sore at every false step. (This is 
similar to Rhus toxicodendron.) The chief pain is 
a burdensome pressure in the forehead or over the 
entire head, with confusion and numb feeling. 
More rarely a sticking pain in the brain or a tear- 
ing in the head and in the eye (resembling Col- 
chicum and Spigelia) ; at the same time the eyes 
are inflamed, the lids are agglutinated, and febrile 
movements occur in the evenings. Eruption and 
creeping sensation on the scalp. 



LEDUM PALUSTRE. 1 77 

Eyes. The pupils are dilated, the power of 
vision is diminished, with flashes before the eyes 
as after running violently. Lachrymation ; the tears 
are acrid, the lids agglutinate, and yet there is no 
pain in them. In the eye a pressure or burning, 
but no inflammation. When inflammation does 
exist in the eye, the pain is tensive or tearing. 

Ears. A kind of deafness as if something 
were laid before the ears. Noise of various kinds 
like the ringing of bells or the rushing of a gale 
of wind. 

Nose. Burning internally in the nose, like coals 
of fire, and the nose is sore on pressure and on 
blowing it (a similar pain in the urethra). 

Teeth. Pains in the teeth are violent, sticking; 
then attacks of intolerable tearing-outward pain on 
one side of the face, head and neck throug-h the 
night, ending with shivering, deep sleep and lack 
of hunger and thirst. 

In the throat sticking pains and sometimes a 
sensation as though there were a plug in the 
throat. (Sore throat with fine sticking pains.) 

The stool is not well defined in the proving. 
Both constipation and a kind of dysenteric diarrhoea 
are described, yet no distinctive characteristics are 
given. It is not probable that Ledum is a remedy 
for either complaint. 

Urine. As regards the urine the same two- 
fold report is given ; sometimes the evacuation is 
frequent and copious ; sometimes it is infrequent 
and scanty. More careful provings on this subject 
13 



i 7 8 



LEDUM PALUSTRE. 



are greatly to be desired, for the symptoms of the 
joints and the fevers would lead us to look upon 
Ledum as a valuable remedy in certain difficult 
forms of gout and of rheumatic gout ; and in such 
diseases experience has shown it to be a mos.t 
useful remedy. Pathology teaches us that in these 
affections the quality of the urinary secretion is 
much altered ; and we should expect Ledum to 
produce analogous alterations in the healthy sub- 
ject. It is probable that the Vienna provings now 
in progress will give us information on this subject. 

The menses are hastened in their oncoming and 
are more copious than is usual, the flow being 
florid. In this respect, the action of Ledum upon 
the mucous membrane of the uterus is analogous 
to that upon the mucous membrane of the respi- 
ratory organs ; for among the symptoms of the 
latter we find nose-bleeding-, the blood being florid, 
and also spitting of florid blood frequently and in 
quantities; and in haemoptysis Ledum is one of our 
most valuable remedies. 

Respiratory Organs. Dyspnoea, constriction of 
the chest, worse on motion, walking, going up- 
stairs ; sometimes a tickling or creeping in the 
trachea and then embarrassed respiration. Cough, 
which sometimes takes away the breath. Remem- 
ber that Ledum was a popular remedy for whoop- 
ing cough. The cough is frequently attended with 
copious expectoration of florid blood, but especially 
at night and early in the morning, with purulent 
sputa. 



LEDUM PALUSTRE. 



179 



Drawing and tearing stitches in the chest, 
which are felt on moving the arms and when sit- 
ting. Pressure on the chest, worse on expiration 
and on moving. 

Back. Pain in back and loins, like a stiffness 
after sitting. Violent cramping pain over the hips. 
It occurs in the evening, and is so violent as to 
take away the breath, and that one cannot rise 
from a chair without aid. Also a drawing and 
tearing which extend from the loins into the occi- 
put, and hot cheeks and inflamed eyes. 

Extremities. In the upper extremities painful 
stitching about the shoulder on raising the arm ; 
also in the hands, ankle, and in the toe and knee- 
joints, especially worse on moving. 

Pressive pains in the shoulder and elbow-joints, 
more violent on motion, as likewise it is in the 
hip-joint. Beside this, there is sensation of heavi- 
ness in the arm, with a feeling of tenseness in the 
muscles of the forearm. 

In addition to these symptoms, we have in the 
carpus and in the thigh a feeling as if the muscles 
had not their proper position. A similar sensation 
about the ankles, legs, the dorsum and margins of 
the feet, and in the toe-joints and on the soles of 
the feet; all worse from motion. 

Also a tearing pressure from the hip-joint down 
to the ankle ; also from the shoulder-joint to the 
hand, worse on motion. 

The limbs generally are languid, tired and lax. 
The small joints of the fingers, the knee-joint and 



i8o 



LEDUM PALUSTRE. 



the feet become the seat of nodosities, concretions 
or " gout stones." 

The feet become and remain swollen. Ledum 
seems to act especially on the left shoulder and the 
right hip-joint. 

PRACTICAL APPLICATIONS OF LEDUM. 

Hahnemann observes that Ledum, from the 
symptoms which it produces, promises to be useful 
only in chronic affections, in which coldness and 
lack of animal heat predominate. This is not 
altogether justified by experience. It restricts too 
much the scope of the drug. 

In a' number of cutaneous diseases, Ledum 
promises to be of service, and it has become an 
established remedy. Thus, according to Riickert, 
" in pimples and pustules on the forehead, and in 
other parts of the body; in red blotches upon the 
face, which has a sticking pain when touched; in 
blotches on the forehead, like those to which 
brandy-drinkers are subject; biting itching on the 
chest, with red spots and miliary eruption." 

In the proving, the eruption is described as: 
" Small round, red spots, insensible, on the inside 
of the arm, on the abdomen and on the feet;" 
" small pimples on the whole body (except face, 
neck and hands), with itching by day and only 
sometimes at night. Scratching relieves for a short 
time only." " Itching of the joints." " Tremendous 
gnawing-itching on the dorsum of both feet; after 
scratching it gets worse and worse ; much more 
violent in the heat of the bed." 



LEDUM PALUSTRE. 181 

It will be applicable for various forms of lichen. 

Teste, a more brilliant than trustworthy writer, 
says that Ledum is a specific cure for wounds with 
pointed instruments and for the evil effects of the 
sting of insects, from mosquitoes up to wasps. He 
applied locally a solution of the 15th dilution. 

But the most interesting application of Ledum 
is in gout and rheumatism. 

The characteristic indication is the aggravation 
by motion, and the midnight aggravation by heat, 
shown by throwing off the bedclothes. The febrile 
symptoms indicate that Ledum cannot be applicable 
in very severe acute cases; it would seem very 
appropriate to such cases as have been brought 
under the injudicious use of Colchicum to a low 
asthenic state. 

It is in such cases that I have found Ledum a 
most serviceable remedy. 

Also in haemoptysis with florid blood and at- 
tended by rheumatic pain. 

Its empirical domestic and allopathic use in 
whooping cough should not be forgotten, though 
Bcenninghausen says of it : 

"This drug (used in some parts of Germany 
successfully in whooping cough as a domestic rem- 
edy) has never been given by me, and cannot, I 
think, be very often indicated." 



RHODODENDRON CHRYSANTHUM. 



SIBERIAN SNOW-ROSE. ALPINE ROSE. 

THIS plant, which is most abundant in the 
Alpine regions of Siberia, but is found like- 
wise in other mountainous and snowy regions of 
Asia and Europe, and perhaps (?) of North Amer- 
ica, is not mentioned in the English and French 
works on materia medica. It is noticed in German 
works on the subject; by some of them a high 
value is set upon certain of its therapeutic proper- 
ties. 

Like most of our valuable remedies, it was 
successfully used by those pioneers of therapeutic 
science, " the old grandmothers," in domestic practice 
for centuries before it attracted the attention of 
scientific men. 

The Cossacks and Mongolians used it as a spe- 
cific for rheumatism and gout. The hunters and 
mountain rangers used to drink an infusion of it 
to remove the weariness and pains from their limbs 
after fatiguing expeditions. These facts were 
brought to the notice of Gmelin during his travels 



RHODODENDRON CHRYSANTHUM. 1 83 

in Siberia, and he was the first to recommend 
Rhododendron in Europe as a remedy for gout 
and rheumatism. The first publication on the sub- 
ject was by Professor Kolpin, of Stettin, in 1779. It 
was used with greater or less success, and recom- 
mended accordingly by many German physicians. 

Our knowledge of its physiological properties is 
derived chiefly from a proving published by Seidel. 
"Archiv," 10, 3, 137, in 1831. 

Seidel introduces his provings with a general 
resume of the action and character of Rhododen- 
dron, as follows : 

" Although many remedies may produce effects 
that are in their general aspect quite similar, neverthe- 
less each remedy possesses certain characteristic 
effects which belong to it alone, and which cannot 
be imitated, and for which no substitute will avail." 
It is these peculiarities of Rhododendron which 
he seeks to unfold to us. 

" Turning vertigo. Early in the morning con- 
fusion of the head ; drawing pressing pain in the 
forehead and temporal region, extending into the 
bones ; headache very markedly increased by drink- 
ing wine; itching of the scalp in the evening; dry 
burning of the eyes; earache; early in the morn- 
ing, obstruction of the nose, especially back in the 
left side of the nose; drawing tearing pain in the 
molar teeth, which is excited by uncertain (stormy) 
rainy weather; pressure in the epigastrium, and 
dyspnoea ; a kind of splenic stitch in the left hypo- 
chondrium; tardy evacuation of faeces, although the 



184 RHODODENDRON CHRYSANTHUM. 



stool is normal ; disposition to semi-fluid diarrhoea ; 
itching, sweat and wrinkling up of the scrotum ; sore- 
ness between the genitals and the thighs; swollen, 
and hard testes ; crushed pain and drawing in the 
testes ; abundant offensive urine ; the suppressed 
menses are brought on ; coryza and other catarrhal 
difficulties ; dyspnoea, rheumatic drawing pains in 
the muscles of the throat and nape of the neck ; 
digging, drawing (gouty, rheumatic) pains in the 
extremities, especially in the bones of the forearms, 
hands, legs and feet ; digging, drawing pains in the 
joints ; occurrence or increase of the pains during 
repose ; increase or re-appearance of the pains in 
unsettled, rough weather, and at the approach of 
storms ; formication and itching in isolated spots on 
the limbs ; weak, paralytic feeling in single limbs ; 
the sleep is sound before midnight ; toward morning 
it is disturbed ; increased warmth in the hands ; 
the disposition is indifferent, with disinclination to 
exertion. 

" It is further to be noticed, that the symptoms 
often intermit for indefinite periods of time, some- 
times longer sometimes shorter (two to twelve days), 
during which nothing will be felt of them ; after 
which they will come again, and be felt for several 
days. They are most likely to come back when 
the weather becomes raw and unsettled, and a 
storm is threatening:. 

"The majority of the symptoms manifest them- 
selves early in the morning, though some are 
experienced only in afternoon or evening." Seidel, 



RHODODENDRON CHRYSANTHUM. 1 85 

therefore, recommends giving Rhododendron in the 
evening, before the patient goes to sleep. 

" The action of Rhododendron on the healthy 
extends over a period of three or four weeks." 

To recapitulate, we find the action of Rhodo- 
dendron to be eminently upon the fibrous and 
serous tissues. The pains in limbs and joints affect 
chiefly the forearm and hand and the leg and foot; 
they seem to have their seat in the bone or peri- 
osteum ; they attack but a small extent of the 
limb at once ; they- disappear and re-appear as it 
were spontaneously and capriciously, nevertheless 
are always worse on the approach of bad weather. 
They are aggravated by motion and toward 
morning. 

Rhododendron acts also upon the testes ; and 
clinical experience has shown it serviceable in 
chronic enlargements and indurations of the testes 
and epididymis, and in hydrocele. * * * 

PRACTICAL APPLICATIONS. 

The only practical application to which I shall 
call your attention is that in chronic rheumatism of 
the smaller joints and their ligaments ; to chronic 
periostitis, and especially to that form of chronic 
rheumatism which simulates rheumatic gout, but is 
distinct from it in this respect : that, as I believe, 
the enlargements of the joints are produced by 
fibrinous deposits and not by chalky excretions. 

In the affection of the great toe joint, often 
mistaken for bunion, but which is really rheumatic, 



i86 



RHODODENDRON CHRYSANTHUM. 



Rhododendron is of great value. For true bunion 
from mechanical pressure Silicea is preferable. 

The application to affections of the testes and 
to hydrocele is apparent. 

It is analogous to and follows as regards the 
testes, Pulsatilla, Aurum, Spongia ; as regards 
hydrocele, Clematis, Graphites. 



KALMIA LATIFOLIA. 



BROAD-LEAVED Kalmia, Calico-bush, Mount- 
ain-laurel, Spoonwood, a native of North 
America, not mentioned in allopathic works on 
materia medica. Bigelow, in his "Medical Botany," 
and Barton speak of poisonous effects from eating 
the flesh of game which has fed upon the berries 
of the Kalmia ; and from eating honey supposed 
to have been gathered by the bees from the blos- 
soms of the Kalmia. 

The proving of Kalmia was made by Dr. 
Hering, of Philadelphia, and first published in the 
"Transactions of the American Institute of Homoe- 
opathy," vol. i., 1845. To this proving were subse- 
quently added the results of further observations 
by Dr. Hering, a proving by Dr. J. Buchner, of 
Munich, and some clinical observations by Drs. 
Okie, of Providence, Williamson and Jeanes, of 
Philadelphia, and Gray, of New- York, and the 
whole was published in part v. of "Hering's Amer- 
ikanische Arzneiprufungen," 1., 1857. 

In introducing his proving, Dr. Hering remarks: 
" Kalmia may be a very important remedy in acute 
as well as chronic diseases. 



i88 



KALMIA LATIFOLIA. 



"As Ledum palustre finds its place in the 
swampy mountain meadows of Germany and north- 
ern Europe ; as Rhododendron chrysanthum adorns 
with its yellow blossoms the elevated plains of 
Asia, so Kalmia latifolia displays itself in the nar- 
row stony valleys of the brooks and smaller rivers 
of North America, and enlivens their banks with 
its evergreen foliage. In May and June it spreads 
out over them a rosy drapery, hanging down in 
such beauty from the rocky walls of the valleys, as 
to strike with wondering admiration even those 
who have been accustomed to the luxuriant glory 
of a tropical vegetation. 

" As the mountain Rhododendron thrives in the 
home of the storms and under the Alpine mists, 
as Ledum flourishes in the regions of the swamp 
clouds of mountain ranges, so Kalmia prefers the 
fogs of the valleys. But all three have a mount- 
ain home. The entire family appears to correspond 
to those great families of diseases which we call 
rheumatisms and gout, and particularly to the 
northern forms of them. In intermittent and par- 
ticularly in remittent fevers with a so-called gastric- 
nervous character, and which run a tedious course, 
all three remedies have shown themselves to be 
indispensable. 

" There are but few remedies in the materia 
medica which have so great a mastery over the 
pulse and with so beneficial action diminish the too 
quick pulsations of the heart, as Kalmia and its 
cognates. Of course this is only in cases which 



KALMIA LATIFOLIA. 



189 



in other respects correspond to the action of this 
family." 

Kalmia, Rhododendron and Ledum act very 
often beneficially, when there is a very frequent 
pulse. 

Next to this family stands the Colchicum family, 
which, singularly enough, is as often applicable in 
gout, and moderates the pulse as well as the Rho- 
dodendron family in rheumatism. But we must be 
careful never to give one after another, never to 
give Kalmia, Ledum and Rhododendron in suc- 
cession, nor (of the Colchicum family) Colchicum, 
Veratrum and Sabadilla. 

In heart diseases that alternate with rheuma- 
tism, or that have developed themselves out of 
rheumatisms, Kalmia promises to be a very impor- 
tant remedy. 

(In a note Dr. Hering says : " This was writ- 
ten in 1843. This conjecture was brilliantly con- 
firmed. In 1853 Dr. Okie cured two cases with 
hypertrophy of the heart arising after acute rheu- 
matism. In one of these cases auscultation showed 
thickening of the valves.") 

The proving of Kalmia is as yet so fragmentary 
that nothing like a complete analysis can be made 
of it. 

Its action upon the vital force is evidenced in 
the modification of the heart's action, which in 
small doses it accelerates, in large doses it moder- 
ates, reducing it almost to a minimum, producing 
at the same time spasm of the glottis, paleness of 



190 



KALMIA LATIFOLIA. 



the face, nausea, obscure vision, coldness of the 
limbs, etc. The pulse is reduced to 35 or 40 
beats. 

The action upon the vital force is shown like- 
wise by the pains, and still more by the excessive 
weariness, languor, lassitude in the limbs and 
especially in the lower extremities, a symptom 
which, unattended with any swelling or evidence 
of inflammation, is quite characteristic of Kalmia. 

The action upon the organic substance is not 
so clearly shown in the proving. Yet so power- 
fully curative has Kalmia proved in grave organic 
affections of the heart and kidney that we cannot 
doubt its power to effect changes in the tissues of 
the body. It produces an itching, erysipelatous 
eruption something like that of Rhus, along with 
dangerous asthmatic symptoms. Also pimples and 
pustules in various parts of the body which itch 
very much, and after being scratched burn. The 
peculiarities of the action of Kalmia display them- 
selves in the coldness and imperfect reaction of the 
fever, in the very great reduction of the pulse from 
large doses, and in the severe pains and great 
lassitude felt in the extremities and particularly 
the lower. The pains extend through an entire 
limb, as, for example, from shoulder down to 
the fingers, from the hypochondrium to the hip 
and from the hip to the heel- These sensations 
indispose the prover to motion and exertion 
of any kind, and are greatly aggravated by 
moving. 



KALMIA LATI FOLIA. 



I 9 I 



SPECIAL ANALYSIS. 

The vertigo is very marked. It accompanies 
every group of symptoms. 

The sensorium is oppressed. Vision is obscured. 

Head. In the head, pain in the vertex, which 
extends up from the cervical vertebrae (resembles 
Belladonna and Silicea). Headache in the forehead 
on waking in the morning ; this is a frequent 
symptom. 

Headache in the forehead and over the eyes 
and nose. The headache extends from fore- 
head and temples down into the canine and molar 
teeth, into the face and the sides of the neck. 

Eyes. In the eyes, pressure and aching, and 
stitches along with rheumatic pains in the limbs ; 
vision obscured along with the vertigo ; sticking 
pain under the left eye. 

Face. Stitches and tearing in the bones of the 
jaw and face. (These symptoms might suggest 
facial neuralgia.) 

The lassitude which characterizes Kalmia is first 
felt in the muscles of mastication. 

Stomach. Eructations, nausea and vomiting 
from large doses ; pressure in the epigastrium, 
relieved by sitting erect, worse when bent over; 
with the sensation as if something were being 
pressed under the epigastrium. (This symptom 
should be remembered in connection with heart 
disease.) 



192 



KALMIA LATIFOLIA. 



Respiratory Organs. Some degree of cough 
from a scratching in the throat, day and night, 
with mucous expectoration in the evening, of a 
saltish taste. 

Dyspnoea, with a feeling as if there were a 
swelling in the throat. Dyspnoea, with pains in 
the limbs. 

Heart. Palpitation of the heart. In large 
doses it diminishes the pulse, with great weakness 
in the arms and legs ; vertigo on every attempt to 
move ; pulse scarcely perceptible, very weak and 
thready. These are the effects of poisonous doses. 
The effects of small doses are to produce palpitation. 

Trunk. Tearing in the nape of the neck; 
darting from nape into the head (Belladonna, Sil- 
icea) ; weak sensation from abdomen into neck. 

Pain in right side of neck, also violent pressure. 
Pain and violent pressure on both sides of neck. 

Violent pain in three upper dorsal vertebrae 
extending through the shoulders. 

Constant pain in the spine, sometimes worse in 
the loins, with great heat and burning. 

<-> o 

Sensation, as if the spine would break from 
within outward. 

Violent pain down the spine. 

Backache during the menses. 

Aching across the loins ; pains also during 
menses ; feeling of paralysis in sacrum ; also even- 
ing in bed, with heaviness in the head. 

Upper Extremities. Pains in the scapulce, going 
through shoulders; tearing pressing in right shoul- 



KALMIA LATIFOLIA. 1 93 

der ; tearing- from right shoulder down the arm ; 
pressing below the left shoulder ; drawing pain in 
the left arm at night ; pains in the left arm. 

Weakness in the arms, with slow pulse ; tearing 
from left elbow along the index finger, which 
is spasmodically flexed ; tearing from the knuckles 
of the left fingers to the elbow ; repeated stitches 
in the hands ; pains close on the wrist ; a kind of 
paralysis in the hands ; pains seem to paralyze the 
hand. 

The pain seems worse in left arm ; it moves and 
does not affect the joints particularly ; it is charac- 
terized by weakness and a paralytic condition. 

Lower Extremities. Stitches into the ossa ilii ; 
tearing on the ossa ilii down the thighs into the 
feet. 

Tearino- in the flesh of the whole left limb. 

Soreness of the left thigh down to the heel ; 
pain in right glutei, in right limb ; in thigh, before 
menses. 

Pain in knees and feet ; aching in calves ; weak- 
ness in calves ; paralytic sensation along shin-bone ; 
aching in feet, in calves, with slow pulse ; jerking 
in heel ; stitches in toes and in soles of feet. 

To recapitulate : We do not find any description 
of inflammation, swellings, redness of the joints, 
nor of deposits in them ; nor is there pain which 
is confined to the joints, aggravated by touch, 
motion, heat, etc. On the contrary, the pains 
extend throughout a great portion of the limbs, 
move quickly throughout their province, and are 
H 



194 



KALMIA LATIFOLIA. 



attended by weakness and by some disturbance of 
the circulation. These paralytic sensations and 
great pains and achings in the limbs seem to be 
characteristic, for they accompany nearly every 
group of symptoms. 

PRACTICAL APPLICATION. 

It is evident that though Kalmia is similar in 
action to Colchicum, Ledum and Rhus, yet it is 
not so clearly called for in articular rheumatism or 
in gout. Its decided action on the heart led Dr. 
Hering to suspect its value in rheumatic heart 
affections, a value established by clinical experience. 

In 1853, I had a most interesting case of this 
kind. A little girl of ten years had been ill ten 
days of what had been called " neuralgia of the 
chest." When I entered the room, her attitude, 
propped up in bed, her anxious expression of face, 
the livid hue of countenance and the visible, tumul- 
tuous and very rapid action of the heart, made it 
evident that she was suffering from violent acute 
endocarditis, — perhaps, also, pericarditis. She had 
just had acute rheumatism, great weakness of 
limbs, but no pain. I gave Kalmia latifolia, though 
her case was pronounced hopeless, and I had no 
hope of her. She recovered completely, continued 
to take the remedy, and, to my surprise, had no 
valvular murmur. She is now grown up and well. 

Dr. Gray, of New- York, guided by a " medium," 
gave Kalmia in prosopalgia ; the symptoms indicate 
its use in that affection. 



KALMIA LATIFOLIA. 



195 



Dr. B. C. Macy, of Dobb's Ferry, published in 
the "American Homoeopathic Review" a most 
interesting case of Bright's disease of kidney cured 
by Kalmia. He was induced to give Kalmia by 
the great and persistent pains in the limbs. 

This is especially interesting, because as yet we 
have no kidney symptoms that would suggest the 
use of Kalmia in Bright's disease. 



SPIGELIA ANTHELMIA. 



A NATIVE of the West Indies and of South 
America. It must not be confounded with 
the Spigelia Marylandica, a native of the United 
States and the officinal Spigelia of the United 
States Pharmacopceia. The latter is a different 
species, is much less powerful in its action on the 
system, and is a well-known and very frequently 
employed anthelmintic, under the name of Pink- 
root. 

The Spigelia anthclmia is - likewise a powerful 
anthelmintic, but it exerts also a powerful action on 
the nervous system, so much so that it is thought 
to have been a chief ingredient in the " poudres de 
succession" of the famous French poisoner, Madame 
de Brinvilliers. 

Our knowledge of its physiological properties 
is derived from Hahnemann's proving in " Materia 
Medica Pura," vol. v. 

The whole plant is used in medicine. A 
general survey of the proving leads us to the 
following 



SPIGELIA ANTHELMIA. 



197 



GENERAL ANALYSIS. 

The action of Spigelia is manifested chiefly 
upon the nervous system of animal life ; and it is 
eminent among our remedies for the extent to 
which its action seems to be exerted upon the 
nerves themselves and their envelopes ; upon the 
nervous centers, however, in so far as we are able 
to make the distinction, its action is probably very 
slight. The nerves of special sense are excited in 
a marked degree, and this without any well-defined 
lesion in the organs of special sense (except the 
eye) ; and even here the exception is more appar- 
ent than real, for the inflammation produced by 
Spigelia is in the sclerotic and choroid, while the 
functionary alteration of special sense is in the optic 
nerve and retina. In this regard, Spigelia differs 
from Belladonna, Rhus and other drugs which 
excite the animal nervous system. In the tissues 
of the eye it excites inflammation, giving a well- 
marked picture of rheumatic sclerotitis. It acts 
decidedly on the trifacial nerve ; producing proso- 
palgia which involves the orbit, the zygoma and 
the superior maxilla ; also on the nerves of the 
tongue ; perhaps, also, on the portio dura. 

The prosopalgia of Spigelia is distinguished by 
sticking burning pains, with subsequent swelling 
and soreness of the parts affected. In this respect 
it closely resembles the prosopalgia of Colchicum, 
from which, however, it is distinguished by the 



198 



SPIGELIA ANTHELMIA. 



exaltation of the special senses and the general 
nervous erethism and excitement, and the intoler- 
ance of pain which characterize Spigelia; whereas 
Colchicum, on the other hand, is distinguished by 
an equally remarkable tolerance of pain and a 
patient, enduring disposition, with a general semi- 
paralytic condition. 

Organic SiLbstance. There is no evidence of 
definite modification of the organic substance of the 
body, unless the action on the pericardium and 
upon the fibrous tissues, which we infer ex usu in, 
morbis, may be so regarded. 

The sphere of action of Spigelia is not exten- 
sive. It embraces only the nerves of animal life 
and of special sense, and the fibrous and muscular 
tissues of the eye, heart, and perhaps of the 
extremities. 

Upon the mucous membrane it produces no 
very definite action, save in the pharynx and pos- 
terior nares. The high repute of Spigelia as an 
anthelmintic might lead us to expect a more decided 
action on the apparatus of digestion. The absence 
of such decided action gives ground for supposing 
that in helminthiasis Spigelia acts rather as a pal- 
liative, killing and expelling the vermin, than as a 
radical curative remedy, modifying that condition 
of things in which they developed and flourished. 

The pains of Spigelia are sticking, tearing and 
burning-pressing. They are aggravated by motion, 
and in the afternoon and at evening, often pre- 
venting sleep. 



SPIGELIA ANTHELMIA. 



I 99 



There is great lassitude and heaviness of the 
limbs ; great restlessness ; great sensibility of the 
whole body to touch. The least touch on any part 
of the body sends a shudder through the whole 
frame. 

(This is different from the sensibility of China, 
which accompanies and characterizes only the parts 
which are already the seat of pain, and in which 
the sensibility is more in imagination and appre- 
hension than in reality.) 

There is no marked periodicity in the symptoms. 

SPECIAL ANALYSIS. 

The sources of knowledge of the pathogenesis of 
the drug are the provings of Hahnemann and his 
associates, in vol. v. of the " Materia Medica Pura." 

Head. Vertigo, as if one should' pitch forward; 
this occurs when looking down (as in Kalmia) ; or 
as if everything were going around when walking, 
relieved by standing still. (Arnica, Colchicum.) 

Memory is weakened ; intellectual effort is irk- 
some. 

Headache. The symptoms are well marked and 
characteristic, and present a good picture of one 
form of so-called " nervous headache." To take a 
general view of the head affections, before stating 
the parts especially acted upon and the varieties of 
sensations, we may say: There are dullness, heavi- 
ness and pain in the head; the pain is much 
increased by shaking and jarring the head, as when 
one walks, and especially by a false step, by 



200 



SPIGELIA ANTHELMIA. 



coughing or sneezing, by moving the facial muscles, 
by speaking aloud, or by any loud noise, as well 
as by touch or bright light (increased sensibility 
of the special senses) ; these things increase the 
pain so that it seems as though the head would 
burst. There is a disposition to press upon and 
support the head with the hand, or to bind it 
around. See Apis. (Keep it warm is Silicea.) 

The varieties of pain are, as affecting the whole 
head, chiefly heaviness or feeling as of a load or weight 
in the head ; a pressing from without inward, much 
aggravated by stooping forward, unless the forehead 
be supported by the hand (Apir, C.iina, Rhus) ; 
a sensation of swashing or surging of the brain 
within the cranium at every step or on the least 
motion or loud speaking ; very severe when the 
head is concussed by a false step, much amelio- 
rated by repose. (Rhus.) This swashing sensation 
is often attended by a tearing digging sensation in 
definite parts of the head, generally semi-lateral, 
as in the left parietal region, the left occiput and 
forehead. 

As regards the localities particularly affected, it 
may be observed that the pain is generally circum- 
scribed, is often confined to one side, more fre- 
quently the left. The occiput is the seat of many 
pains which extend into the nape, causing stiffness 
of the neck and at the same time restlessness. In 
the forehead, and especially in the frontal protu- 
berances, we find : Pulsating stitches ; pressure from 
without inward; boring and burning pain, the lat- 



SPIGELIA ANTHELMIA. 



20I 



ter (burning) is probably superficial, and indicates 
an affection of the supra-orbital nerve. 

In the frontal protuberances, tearing pains 
extending into the eye, and aggravated by motion 
of the globe of the eye. 

In the temporal region we find pulsating 
stitches ; pressure inward, and burning extending 
into the zygoma. As to the time of their occur- 
rence no special mention is made save once, when 
the pains for the most part occur in the evening 
and continue violent through the night. 

The aggravations and ameliorations are uniform 
and as have been stated. The whole head is 
externally very sensitive to touch, and this is 
aggravated by motion of the scalp. 

In the skin of the temples, forehead and eye- 
brows, a burning, tingling pain is felt, which 
extends down the cheek or into the eyes, and is 
aggravated by touch and motion. Near the orbit, 
swelling of the sub-cutaneous tissues occurs and of 
the skin, which is sore when touched. 

The eyes also are affected in a special manner 
by Spigelia. Its action is exerted on all the tis- 
sues, but especially on the muscular and fibrous 
tissues and upon the function of special sense. In 
addition we have, especially in the left orbit, neu- 
ralgic pressing pains extending down to the zygoma 
and leaving, after the pain subsides, a tumor which 
is sensitive to the touch. (Colchicum.) 

Compressive pain, generally in the orbits. The 
margins of the eyelids are sore, burning and pain- 



202 



SPIGELIA ANTHELMIA. 



ful. In the lids and their margins fine stitches, as 
from needles. In the margin of the left lower lid 
a fine cutting, as with a little knife. With these 
exceptions, which seem to imply an organic affec- 
tion, the lids are not acted upon in their substance. 
On the other hand the innervation of their muscu- 
lar tissue is modified as follows, along with the 
nervous affection of the pupil and retina : The 
upper lids are relaxed and paralyzed ; they can be 
elevated only with the aid of the hand, the pupil 
being- at the same time dilated. 

The conjunctiva is moderately inflamed ; we 
have pain as from sand in the eye, muco-pus and 
acrid lachrymation. 

The globe of the eye is seriously involved, as 
we gather from the following symptoms : Dull and 
flat aspect of the eye ; supra-orbital pains ; redness 
and inflammation of the sclerotic with ptosis ; pain 
in the eye and brow ; the eye is painful when 
moved, and feels tense, as if it were too large for 
the orbit; sticking pain in the eye, also, when it is 
moved ; digging pain in the middle of the eye 
(violent) with ptosis ; pressure in the eye, from 
without inward ; the eye is painful when moved 
in any direction ; intolerable pressive pain in the 
eyeball, worse from moving the eye ; in order 
to look around, rather than move the eye in 
the orbit, one moves the whole head ; heat and 
burning pains in the eye, with perverted vision, 
occasional spasmodic, involuntary motions of the 
eyes. 



SPIGELIA ANTHELMIA. 



203 



As regards the secretions, we have moderate 
acrid lachrymation and a formation of muco-pus. 

Vision. The special sense of the eye is exalted. 
The sensibility of the retina is increased, inducing 
photophobia, and perverted, causing illusions, as if 
hair or feathers were upon the lashes, aggravated 
by wiping the eyes, as if sparks or a sea of fire 
were before the eyes. The pupils are dilated. 
Vision is also impaired. 

Ears. The ear, the zygomatic region, the max- 
illae and the throat are involved in an affection, 
evidently neuralgic, characterized by pressing and 
occasional burning pain extending through these 
regions and aggravated by loud noise. 

Beyond this, the ear is affected as follows : In 
the external ear, pinching, drawing, itching. In 
the meatus auditorius, pressure as from a plug deep 
in the meatus, extending to the zygoma and molar 
teeth. 

In the inner ear, occasional dull, boring stitches 
extending into the throat. 

In the ear generally, sudden stitch extending to 
the eye, zygoma, throat, jaw, teeth. 

The special sense of hearing is exalted, in con- 
nection with headache. Loud noises are painful. 
Otherwise we have deafness, sensation as if the 
ears were loosely stopped, with ringing and rustling 
sounds, and yet without deafness. When speaking, 
the sound of one's voice resounds like a bell through 
the brain. 

Moreover, there are signs of catarrh, as sudden 



204 SPIGELIA ANTHELMIA. 

obstruction of the ears on blowing the nose, 
relieved by working the ringer into the meatus. 
Roaring before the ears, rustling and rushing as of 
wings, ringing of distant bells. 

Itching of the alae nasi of the nostrils, and of 
the dorsum of the nose. Unpleasant sense of 
obstruction at the root of the nose. 

The part of the face chiefly affected is the 
zygomatic region. In preference, the left side is 
affected. The pains are burning or tearing-press- 
ive, leaving a dull sensation of swelling when the 
pain abates. Stitches from the upper maxilla to 
the vertex and in the cheek and temple in front 
of the ear. 

The facial muscles are distorted and swollen ; 
the whole face is puffed in the morning, with a 
feeling of illness. (This and nose-itching signs of 
helminthiasis.) 

Burning and tension in the upper lip. 

Painless pustules upon the chin. 

In the lower jaw, painful pressure upon the 
angle. In the articulation, pain as if dislocated only 
when chewing ; otherwise a dull pain. 

In the teeth, drawing, fine sticking or sudden 
jerking pains at short intervals in the molar teeth, 
generally in several or in all the teeth simultane- 
ously, but most severe in the carious teeth. The 
toothache is worse at night and after eating, though 
not while eating ; also by cold air and water, and 
particularly at night. It is accompanied by spas- 
modic closure of the jaw. 



SPIGELIA ANTHELMIA. 



205 



The tongue presents also neuralgic phenomena, 
confined chiefly to the right side ; fine stitches, 
boring stitches from behind forward, with a sour 
taste. 

The remaining symptoms belong rather to a 
gastric affection ; the tongue is full of cracks, as if 
about to lose its epithelium. The tongue and pal- 
ate have vesicles, which burn when touched. The 
tongue pains, as ft" swollen posteriorly. It is coated 
white. 

Swelling in the fauces, with enlarged and pain- 
ful cervical glands and pain on swallowing, with 
difficulty in opening the mouth. This affection 
is preceded by chill and shivering. Stitches in 
region of larnyx, worse and worse, relieved by 
swallowing. 

Mucus accumulates in the fauces. It is repul- 
sive to the taste, and cannot be swallowed. 

Offensive, putrid taste, and offensive odor from 
the mouth (helminthiasis), yet food has its natural 
good taste. 

Great dryness of the mouth in the morning, as 
if full of pins, yet not really dry. No thirst. 

Appetite sometimes gone, sometimes greatly 
increased (helminthiasis) ; great thirst. 

Gastric Symptoms. Frequent eructations after 
a meal. Nausea, as from too long abstinence. 

Epigastrium. Pressure, as from a load or ball, 
relieved by pressing with the hand ; feeling as if it 
would be relieved by an eructation, which, however, 
is impossible. 



206 



SPIGELIA ANTHELMIA. 



Stitch in the epigastrium, with dyspnoea, aggra- 
vated by respiration, relieved by lying down. 

Hypochondria. In the left hypochondrium, 
stitches compelling to bend forward, worse on 
inspiration ; these are sharp, extending to the crista 
ilii, only on motion or inspiration. 

In the right, deep inwardly ; sharp stitches at 
regular intervals, relieved by full inspiration, recur- 
ring on expiration (evidently not inflammatory) ; 
stitch on making violent exertion only. 

A bdomcn. Flatulence ; audible rumbling and 
gurgling, attended occasionally by pain, and pre- 
ceding diarrhoea. 

In the umbilical region, cutting pain with chill, 
diarrhoea. Pinching pain, as if all the intestines were 
twisted up, with dyspnoea and great anxiety. The 
abdomen is sensitive to touch. This group is 
attended by flatulence, and followed by diarrhoea. 

In the abdominal ring, cutting and sticking, 
with protrusion of the old hernia. 

Stool. Spigelia produces irritation in the rectum, 
much tenesmus, without or after stool, increased 
discharge of thick mucus; and occasional stools 
consisting first of faeces, solid or soft, and then of 
tough yellow mucus. 

Urinary Organs. Frequent tenesmus of the 
bladder, and copious discharge of urine with white 
sediment. Also on externally pressing the blad- 
der and on rising from a seat, incontinence of 
urine, followed by burning in the urethra. 

Sexual Organs. Frequent erections with lustful 



SPIGELIA ANTHELMIA. 



207 



thoughts, but no sexual instinct. Discharge of 
mucus from the urethra at stool. 

Itching and burning in the right testis and in 
the penis. Tingling in the scrotum. 

Respiratory Organs. Nasal catarrh, first dry, 
then fluent ; discharge of bloody mucus from the 
nose. 

Nasal catarrh, with hoarseness and heat of the 
body, without thirst or sweat. Profuse coryza, 
headache and depression. 

The peculiarity of the Spigelia nasal catarrh is 
this : The discharge through the anterior nares is 
but slight, while through the posterior nares into 
the pharynx it is great and constant, and very 
sensibly felt. Sometimes it is quite liquid, but gen- 
erally tough, stringy, and in such quantity as to 
threaten suffocation unless frequently removed by 
hawking. This prevents sleep at night ; trickling 
into the larynx, also, it causes a kind of suffocative 
cough. 

Cough. Spigelia is not prominent among the 
cough-producing drugs. It causes a spasmodic 
cough which stops the breath ; is provoked by a 
tickling deep in the trachea, is violent, dry •and 
hollow, and is excited especially by stooping for- 
ward. 

Respiration. Several symptoms betray impeded 
respiration, the impediment seeming to result from 
sticking pains in various parts of the thorax, which 
are independent of respiration, though aggravated 
by it. 



208 



SPIGELIA ANTHELMIA. 



Chest. Pressure upon the chest in various 
localities, under the clavicle, over the center of the 
chest, over the whole chest, and over the xiphoid 
cartilaofe. 

Stitches in various parts and on both sides, more 
frequent on the left side, from within outward ; 
aggravated by inspiration and by motion. 

The following symptoms deserve special notice : 
Violent stitch in the left side, just under the heart, 
recurring periodically ; stitch " in the diaphragm" 
on the left side, so violent as to arrest respiration; 
dull stitches (Colchicum) synchronous with the 
pulse in the region in which the heart's impulse is 
felt ; stitches between this latter spot and the epi- 
gastrium. These symptoms, together with the fol- 
lowing, which denote modified action of the heart, 
viz.: very violent pulsation of the heart, audible to 
the patient and visible to the by-stander; violent 
palpitation and anxiety; tremulous motion of the 
heart; palpitation increased by sitting down and 
bending forward, and by deep inspiration and 
retention of breath; palpitation as soon as he sits 
down after rising in the morning; and in the pre- 
cordial region a heavy, painful pressing load, 
causing constriction and anxiety, with cutting and 
griping, as from wind in the abdomen; — these two 
series of symptoms point clearly to an organic 
affection of the heart or pericardium, such as clini- 
cal experience has proved to find its curative 
agent in Spigelia. 

Back. In the lumbar, dorsal and scapular 



SPIGELIA ANTHELMIA. 200 

regions various stitching pains are noted, generally 
worse on motion and inspiration, along with gen- 
eral lassitude. 

Extremities. Pains, aching, restlessness, isolated 
tingling and numbness. Similar sensations to those 
already described in other parts of the body. 

Upper Extremity. In the shoulder, arm and 
forearm, sticking and pressing pains, with a sen- 
sation of lassitude and weakness. The two symp- 
toms, sensation in the forearm, as if the bones were 
compressed by tongs and the pressing, cutting, 
tearing pains in the wrist and finger joints, worse 
by motion, indicate the action of the drug upon 
the nervous and fibrous tissues respectively. The 
numbness and paleness of the hand (Symptom 381) 
does not indicate any variety of organic paralysis 
or depressed vegetation, but rather such a condition 
as results from pressure on a nerve, or when the 
hand, in popular phrase, "goes asleep." 

Lower Extremity. The action of the lower 
extremity is more decided and more definite. As 
in the upper extremity, we have lassitude, fine 
sticking pains and spasmodic twitching of individual 
muscles. In addition, there is very great restless- 
ness of the limbs, especially at night, preventing 
sleep and causing constant motion and flexion and 
extension of the limbs ; this is attended by digging 
pain in the left knee (Aurum, Rhus toxicodendron, 
Taraxacum, Causticum). The knees are sensitive, 
and are painful when walking, and worse the longer 
the walk is continued. Luxated pain in knee, 
15 



2IO 



SPIGELIA ANTHELMIA. 



causing limping ; sticking in the calf and pulsation in 
patella when knee is extended. Ankle; boring pain 
on flexion, as if tendons were too short; tearing 
stitches in the feet; soles sore when stepping. 

Sleep. Frequent and great sleepiness, yet ina- 
bility to fall asleep until very late in the evening; 
sometimes from great restlessness of limbs. 

Sleep disturbed by lively dreams ; he is fatigued 
on waking; more tired in the morning than on 
going to bed. 

Fever. The entire paroxysm is often without 
thirst. Chill partial ; frequent sensation of heat in 
the body ; none external. 

Chill generally in the morning, partial and wan - 
dering, often not followed by heat; it starts from 
the epigastrium and extends to the back, head and 
upper extremities. 

During the heat, desire for external heat. The 
hands feel warm to each other but cold to the 
face ; heat is partial. 

Disposition. Irritable, excitable, with depressed 
anxiety for the future, and despondency. 

PRACTICAL APPLICATIONS. 

Hahnemann remarks in his introduction to the 
proving of Spigelia (A. M. S. R., 5,238): 

" This annual plant, which was first used in 
South America as a domestic cure for lumbricoides, 
became known to our physicians about eighty years 
ago, who, however, have learned since that time to 
use it for nothing else than what the simple 



SPIGELIA ANTHELMIA. 



2 1 I 



negroes of the Antilles first taught them, viz., to 
expel the lumbricoides. 

" Yet let one only reflect that the accumulation of 
lumbricoides in the intestines is never an individual 
independent disease, but only a symptom of some 
other fundamental disease in man, and unless this be 
cured, the worms, although some may be driven away 
will yet perpetually re-appear in the intestines. 

"It would therefore be foolish to use so 
extremely powerful a drug as Spigelia merely for 
the expulsion of worms, if this plant did not, at 
the same time, remove the disease which lies at 
the foundation of the existence of the worms. 
This it can do, as many cases show, in which the 
patients recover, even without having passed a 
single worm. 

" Spigelia, however, has short-sightedly enough 
been regarded and used only as an anthelmintic. 
When people know not how to devote this most 
precious remedy to a more important use (a few 
cina-seeds would do for this), they act as inappro- 
priately as they would do in applying a costly 
machine to do a trifling bit of work. The won- 
derful and many-sided power of this drug shows 
a much higher design for it than to bring a 
few worms from the intestine." 

1. The chief indications are in semi-lateral 
neuralgic headaches involving the eye, chiefly the 
left side. 

2. In prosopalgia, involving the eye, the zygo- 
ma, the cheek, teeth and temple. 



212 



SPIGELIA ANTHELMIA. 



3. In rheumatic sclerotitis. 

4. In pericarditis and endocarditis with stitches 
and violent pulsation. 

It comes after Aconite ; competes with Bryonia ; 
precedes Spongia and Lachesis, Arsenicum and 
Lithium. 



ATROPA BELLADONNA. 



DEADLY NIGHTSHADE. 



HE whole plant is used in medicine. It has 



classed among- the "narcotics" or the "cerebral 
stimulants." In the seventeenth century first used 
in medicine to resolve tumors and "cure cancer." 

The herbivorous animals devour Belladonna with 
impunity. 

Cases of poisoning with Belladonna are abun- 
dant in medical literature. It is from a collation 
of these cases, along with a very thorough and 
exhaustive proving on the healthy subject by Hah- 
nemann and his pupils, that we derive our knowl- 
edge of its physiological action. 

As this drug is in very common use it may be 
well to make a minute and careful study of its 
action. As a preliminary, the following sketch of 
the action of a poisonous dose may be of interest: 

" The eye became dry, the conjunctival vessels 
fully injected ; there was a total absence of lachry- 
mation, and motion was attended with a sense of 




as a dangerous poison. 



214 



ATROPA BELLADONNA. 



dryness and stiffness. The face was red and tur- 
gid, and the temperature and color of the surface 
considerably augmented. The face, upper extremi- 
ties and trunk exhibited a diffuse scarlet efflores- 
cence, studded with innumerable papillae very 
closely resembling the rash of scarlatina The 
pulse was full, from 120 to 130. The feeling in 
the head was that of violent congestion, a full, 
tense, throbbing state of the cerebral vessels, — 
identically the same sensation that would be pro- 
duced by a ligature thrown about the neck 
and impeding the return of the venous circu- 
lation. The tongue, mouth and fauces were as 
devoid of moisture as if they had been composed 
of burnt shoe-leather. The secretions of the 
glands of the mouth and of the saliva were entirely 
suspended. A draught of water, instead of giving 
relief, seemed only to increase the unctuous clammy 
state of the mucous membrane. About the pharynx 
this sensation was most distressing. It induced a 
constant attempt at deglutition, and finally excited 
suffocation and spasms of the fauces and glottis, 
renewed at every effort to swallow. A little saliva, 
white and round like a ball of cotton, was now 
and then spat up. The power of Belladonna over 
the secretion of urine seems very great. I am 
confident I passed in the course of an hour three 
pints of urine, accompanied by a slight strangury 
at the neck of the bladder." 

This hasty description by an allopathic observer 
corroborates the observations of homceopathists. 



ATROPA BELLADONNA. 2 I 5 

GENERAL ANALYSIS. 

The action of Belladonna on the system is so 
general and so complex as almost to defy analysis. 

1. On the vital forces of animal life its action 
is preeminent. The special senses are all affected 
as regards the intensity, and perverted as regards 
the character, of their function. The voluntary mus- 
cular system is affected, tonic and clonic spasm 
being produced. The involuntary muscular fiber is 
affected, as we infer from relaxation or abnormal 
rigidity of the sphincters, dilatation of the iris, pal- 
pitation of the heart, etc., and throbbing of the 
arteries. The sensorium is eminently affected, 
delirium, illusions, exaltations, mania, stupor, being 
different phases of Belladonna poisonings. 

Yet, violent as this action is, we see no perma- 
nent paralyses. 

2. On the organic substance Belladonna acts 
less profoundly. No evidence of any dyscrasia. 
The skin is affected as by the scarlatinal eruption. 
The sub-cutaneous and sub-mucous cellular tissues 
are inflamed, as also the true skin, — witness the 
erysipelas. The bladder and the uterus, and also 
the lining membrane of the rectum, are structurally 
altered. 

3. Sphere of action. Chiefly the skin and 
mucous membrane of mouth, fauces, genito-urinary 
organs and the eye ; muscular system, nervous 
system in every branch. Digestive organs not 
affected, nor the serous and osseous and fibrous 



ATROPA BELLADONNA. 



tissues. Glands eminently affected ; ovaries, parotid, 
lymphatic. Uterus and appendages also ; skin, 
erysipelas. 

Periodicity not marked ; cough worse at night 
Characteristics. Pains gradually increase till 
intolerable ; then suddenly decline and re-appear 
elsewhere. Painful spots, sore on gentle pressure, 
yet tolerating firm pressure, as ischia and ovary. 
Always attended by red face, full, hard pulse, 
throbbing carotids, wild delirium. 

Head. Sensorium. i. Dizziness, as if all things 
were going round and swimming before the eyes, 
such as one feels after whirling around, with a 
turning in the epigastrium. It occurs also while 
walking, with incoherent rpeech. It occurs on 
moving and when at rest ; is better in the open air 
and worse in the chamber. It is conjoined with 
feeling of stupidity in the head. 

2. Confusion of the senses a whole day ; he 
knows not what he does ; the whole head is con- 
fused. A feeling as if drunken ; as during a 
debauch, immediately after a meal. Confusion and 
dullness, as if a pressing cloud were drawn over the 
forehead. These are aggravated by alcohol and 
by motion. As concomitant symptoms, are npted 
swelling of the cervical glands and swollen, red face. 

3. Indisposed to mental labor, feels unstrung. 

4. Perception confused ; he knows not whether 
he is asleep or awake; still he dreams, though 
awake. Elevated, deceptive fantasies ; he sees and 
hears objects not present, not existing. 



ATROPA BELLADONNA. 



Primary action, probably to excite and give 
fantasies. 

5. Lies often unconscious ; convulsions. 

6. Memory enfeebled during the headache ; 
generally enfeebled. 

Headache distinctly marked. 

I. Consider first the parts of the head affected : 

1. The whole head, by a feeling of heaviness 
and pressure, as if drunken, or pressed by a stone; 
a pressure as if the head were screwed together 
and made narrower, and a consequent feeling of 
pressure outward, as if the head would burst. 
Altogether the mass of symptoms, however, relate 
to the forehead, orbits and temples ; the right orbit 
and supra-orbital region being especially attacked. 
We 'find : 

2. In the forehead exclusively the heaviness 
and pressing pain. The pressing, as of a weight, 
is distinct and marked, pressing down so low as to 
hinder the opening of the eyes, with a feeling as 
if something had sunk down in the forehead. The 
pain affects the eyes also, which, from the intensity 
of the pain, are kept shut ; they are painful to the 
touch. Pressing pain in the forehead and frontal 
eminences, ceasing occasionally only to return 
again with greater intensity. This pressing is from 
within outward in a majority of cases. This pain 
in the forehead is aggravated by motion, removed 
by lying down to recur on rising. Not affected 
by eating, etc. ; made worse by the open air. 

3. In the orbits. Just over the orbits and just 



2l8 



ATROPA BELLADONNA. 



over the root of the nose, the pressing and pressing 
drawing pain is most intense (458). There is also 
a sticking and tearing and a drawing pressing from 
the temples to the orbits, especially on the right 
side. 

4. In the vertex a single symptom, a digging 
and tearing pain and sensitiveness. 

II. The kinds of pain are various, being mov- 
able and stationary; the latter predominate. They 
are heaviness and pressing, which are felt in the 
whole head, but especially in the forehead. Gnaw- 
ing and throbbing, all felt more in the frontal than 
in other regions. 

The former are sticking, tearing and jerking 
pains. 

From within outward, as if the brain were too 
large. 

As concomitant symptoms, are noted, acuteness 
of the senses, eyes mUst be kept closed ; great 
irritability about trifles. 

III. Conditions. 

The symptoms are aggravated in general by — 

1. Stooping forward, which causes a feeling as 
if all would pass out through the forehead. 

2. Coughing or any sudden motion which 
shocks the head. 

3. Stepping when walking, he feels the brain 
quasi rise and fall with every step. 

4. Rising up, from sitting or reclining posture. 
Ameliorated by lying down and by bending 

backward. 



ATROPA BELLADONNA. 



219 



In addition to this, throbbing of the vessels is 
a marked symptom of Belladonna, occurring in the 
head and whole body simultaneously. 

Heat in the head, redness of the face with the 
headaches. 

Head. External. Heat of the head a con- 
stant symptom. The pains in the scalp and 
forehead are chiefly drawing and drawing together 
or contracting pain and a cramp-like, compressive 
pain. These occur chiefly in the right side of the 
head. The compressive, cramp-ljke pain occurs in 
the frontal eminence and draws downward over the 
zygoma to the inferior maxilla (a kind of neuralgia). 

The forehead itches and is sensitive to the 
lightest touch. 

Pimples occur on the temples, and the head 
swells and the body is red. 

Face. All symptoms agree ; the face is red, hot 
and swollen. 

The redness is of various degrees, from a scar- 
let, confined to a small part of the cheek, to a 
deep, livid, bluish-red, pervading the whole face 
and invading the chest. The heat is of' various 
degrees, felt generally in the parts that are red, 
while in other parts, the cheeks especially, there is 
boring and throbbing pain. 

The swelling may be scarcely perceptible, or 
intense, occupying cheeks, nose and lips ; hard and 
hot. Aggravated by motion and touch, and accom- 
panied by violent headaches and by paleness and 
coolness of the rest of the body. 



220 



ATROPA BELLADONNA. 



Eyes. The eyes appear protruding, with greatly 
dilated, insensible pupils; under still more powerful 
doses the eyes are distorted, with red and swollen 
face ; they glisten and move convulsively with con- 
vulsive movements of the hands. Morbid changes 
are manifest. The eyes become injected, with 
pressing pains. They are inflamed, with enlarged 
veins and itching and sticking pains and increased 
lachrymation. The left caruncle is inflamed and 
suppurates, with burning pain, and a white vesicle 
forms on the left (much dilated) pupil. 

The sensations vary from those of slight con- 
gestion to those of violent inflammation ; pressing, 
as when hard spring water gets into the eye ; 
pressing deep in the orbit when the eye is closed ; 
these are attended by lachrymation. The pains are 
these sensations intensified, with the peculiar indi- 
cations of inflammation superadded. Pressing pain, 
as if the eyes were full of sand, compelling to 
rub them ; and heat, as if they were surrounded by 
vapor. Pain, as if the eyes were torn out; then, 
again, as if they were pressed into the head ; and 
in addition, a pain pressing from the forehead upon 
the eyes. Tearing pain in the eyes, proceeding 
from the left canthus. A biting in both eyes, with 
burning and sticking from without inward. Pain 
in the orbits, as if the eyes were torn out ; some- 
times, again, as if they would be pressed into the 
head, with a pressure on the eyes coming from the 
forehead (458). Burning with itching; desire to 
rub the eyes and relief thereby. 



ATROPA BELLADONNA. 



221 



The secretion is early affected. First, a burning 
dryness, then involuntary lachrymation, with the 
pressing in the eyes. It is altered in character; 
the eyes are stuck together by pus in the morn- 
ing. 

Lids. The lids partake of the peculiar aspect 
of the eye ; they are dilated, stand wide open. 
Various sensations are noted, both nervous and 
inflammatory. Trembling and twitching ; heaviness; 
they fall shut in the morning with lachrymation. 
Throbbing pain, with inflammation and lachryma- 
tion. Itching and sticking, relieved by rubbing ; 
painful to the touch. 

Sight. The sight is specifically affected in a 
striking manner. Not only in degree but also in 
kind is the action of the optic nerve influenced. 

As to degree, i. e., in sensibility, it is first in- 
tensified, photophobia ; and second blunted, hence 
diminished vision with dilated, immovable pupils ; 
can see nothing but the white margin of the book, 
which appears black. As to kind, there are 
abnormal action and illusions. As to the former, 
objects appear double. Objects when near at hand 
are not seen at all; when distant they appear 
double. They appear manifold, are seen obscurely 
and upside down. As to the latter, letters tremble 
and are parti-colored, gold and blue. Bright red 
rings are seen around the candle. Flames and 
clouds appear. A white star is seen on the ceiling 
and light silver clouds. 

Ears. External. Various pains about the 



222 



ATROPA BELLADONNA. 



region of the ear involving the zygomatic region, 
the parotid gland, the maxillary articulation, the 
cartilage of the ear, and the muscles behind the 
ear down to the neck. 

These pains are, as to the zygomatic process, 
squeezing pressure on the left zygoma, tearing and 
drawing and pressure under the right zygoma. In 
the maxillary joint a violent sticking extending into 
the ear, induced by chewing and continuing after 
chewing ; fine stickings. In the parotid, stitches 
extending into the ear; violent stitch extending 
into the external ear, where it vanishes like a 
cramp, returning the same day at the same hour. 
In the cartilage of ear a tearing pain, and pressure 
in the lower and posterior part. In the muscles 
behind the ear down the neck, pain as if strongly 
pressed ; the same in muscles of forehead. See 
below, under internal ear. 

Meatus. Stitches in external meatus, unpleasant 
pressure like boring with finger, as if from 
pressure. 

Internal. Various sensations and pains. A 
pinching first in right, then in left ear, just after 
swallowing ; unpleasant feeling in right ear as if 
torn violently out of head. Alternate tearing out 
and pressing in pain in ears and temples, alternat- 
ing with similar pains in the orbits. Earache in 
left ear, sharp shocks, with squeezing; in right ear 
boring pain, pressing, tearing behind the right ear; 
a fugitive stitch from ear to chin ; stitches also with 
eructations tasting of food. Drawing from ear to 



ATROPA BELLADONNA. 



223 



nape. Violent pressure in mastoid process below 
ear and cutting shocks in it. 

Secretion. Discharge of purulent moisture from 
the ears for twenty days. 

Sense of Hearing, Sensibility. Deafness, with 
stitches in the ear. Increased sensibility (secondary 
probably, D.). Deafness as if a skin were stretched 
before the ear. 

Various Illusions of Hearing. First, noise of 
trumpets and rushing in the ears ; then a buzzing 
and humming, worst when sitting, better when 
standing and lying, still better when walking. 
Rushing noise, with dizziness and bellyache. 
Morning, immediately after waking, a rushing and 
bubbling in front of the ears. 

General Complications. 1. Of the ears and 
temples pains with orbit-pains. 2. Pains in mus- 
cles of neck and occiput. 3. Ear-pains with swal- 
lowing and eructations. 

Nose. In appearance the nose becomes suddenly 
red at the point, with burning sensation. Various 
pains and sensations are produced. In the bones 
of the nose a pressing pain just above the ala, 
pain as if beaten when touched ; above the left 
half of the nose a painful drawing, a tickling 
removed by rubbing; in the point of the nose 
stitches throughout the night and burning with 
sudden redness. 

Eruptions appear on nose as well as lips, etc. 
At the root of the nose two small red pimples, 
painful only when touched, as if ulcerated ; and on 



224 



ATROPA BELLADONNA. 



cheeks and nose papules, which quickly fill with 
pus and cover themselves with a crust. 

Sense of Smell. Increased sensibility ; smell of 
smoke from tobacco and soot is intolerable. Ab- 
normal smells as of rotten eggs (early). 

Nostrils, Pains. Left nostril painful, ulcerated 
together in morning. Painful ulceration of nostrils 
just on the side where they join the lip. Nostrils 
and corner of lip ulcerate, but neither itch nor 
pain. Epistaxis night and morning. 

Lips. Majority of the symptoms are those of 
organic nature, eruptions or other cutaneous affec- 
tions. On the upper lip, papules near the ala of 
the nose, covered with a crust, and a correspond- 
ing one on the lower lip, with a biting pain as ii 
from salt water. Papules itching when touched. 
On lower lip burning pain and little vesicles ; 
between lip and chin pustules with burning pain, 
especially at night. In the corner of the mouth 
ulcerated spot with tearing pain ; rawness as if 
about to ulcerate. Little pale red papules painless. 
There are thus eruptions about the external sur- 
face of the lips ; these are papular, running some- 
times into ulcers which cover themselves with a 
crust. The pains are drawing, tearing, biting and 
burning. In addition the upper lip swells and 
becomes red. Functionally the lips are affected, 
spasmodic motions are observed, also distortions 
of various degree and foaming at the mouth. 

Chin. Eruptions as on the lips, with similar 
pains. 



ATROPA BELLADONNA. 



225 



Jaws. Symptoms referring to motion of the 
jaws, from sensation of spasm up to absolute lock- 
jaw, resisting violent extraneous force. A large 
furuncle on the angle of jaw, hard and painless till 
touched. 

Glands of Neck. Drawing and tensive pains 
in the glands ; the glands are swollen and painful 
at night, but not on swallowing (400—403). 

(403-413.) Muscles of Neck. Spasmodic ten- 
sion and cramp-like sensation in the muscles of the 
neck (without motion). Actual spasm, the head is 
drawn backward, burying in the pillow, with draw- 
ing and pressing pains in the muscles of right side; 
stiffness of muscles. In the nape of the neck, close 
to the occiput, a pressing pain not affected by 
motion ; and lower down, about the second and third 
cervical vertebrae, violent frequent stitches by hold- 
ing head erect. On the side of the neck, arterial 
pulsation is felt. In the laryngeal region pressing 
sensation on the left side, increased by touch ; fine 
stickings in throat-pit. 

Teeth. As a generality, various symptoms 
taken from records of poisoning in very high 
degree, whole muscular system being excited to 
spasm. Gnashing of teeth, with foaming at the 
mouth, smelling like foul eggs (epilepsy) and spasm 
of rig-fit arm. 

Gums. Painful swelling on the right side, with 
fever and chilliness. Vesicle under one of the front 
teeth, painful as if burnt. The gums are painful 
to the touch, as if ulcerated ; they are hot and 
16 



226 



ATROPA BELLADONNA. 



throb, with pain in the throat. Gums bleed easily 
by a decayed tooth, without pain. 

Toothache. Various kinds of pain, the symp- 
toms being distinctly marked. The pains are 
variously characterized, according to their intensity; 
the majority are drawing ; then tearing, jerkings, 
borings and soreness ; digging pains are also men- 
tioned. They occur for the most part in decayed 
teeth, and if severe, the pain extends to the whole 
row of teeth in that jaw on that side; the right 
side is affected by preference. If the pain is severe, 
or after it has lasted some time, the gums and 
cheek become swollen, painful and hot to the touch. 

The pain gradually rises in severity to a great 
height, and gradually subsides. 

It occurs chiefly at night, or, at least, is much 
worse at night, preventing sleep; still, it never 
entirely ceases during the day, to come again at 
night. It is aggravated by touch, by the open air, 
and after eating, although often during the act of 
eating it is relieved (perhaps because nervous sys- 
tem being affected attention is withdrawn). The 
chief complications are with pain in the ear. A 
violent toothache is attended by stickings in the 
ear ; the pains seem to shoot down from the ear to 
the teeth. 

Mouth. Sensation of breadth and depth, as if 
the tongue were lower down than usual. 

Tongue. Various sensations, as if lower down 
in the mouth than usual, as if asleep, numb or 
dead; or covered with fur in the morning, and a 



ATROPA BELLADONNA. 22 7 

feeling of coldness or dryness on the anterior half 
of the tongue. Various pains; painful to the 
touch; biting pain, as from a vesicle in the middle 
of the white-coated tongue ; on the tip, a feeling as 
of a vesicle, burning when touched. Fissured, white- 
coated (3d Stapf); the papillae are of a deep red, 
inflamed and greatly enlarged (3d Stapf). The 
tongue trembles and stutters. 

Speech. Stammering, weakness of speech, with 
full consciousness and dilated pupils. Paralytic 
weakness of speech organs. Difficult speech, dys- 
pnoea and weariness succeeding the anxiety. Speech 
difficult, the voice is piping. Low speech, attended 
by headache, as if brain were pressed out close 
over the orbits in the forehead, which prevents 
opening the eyes and compels to lie down, with 
very great contraction of pupils. 

Secretion of Mucus and Saliva. Increased, with 
fissured, white tongue; increased and tenacious 
hanging and running out of the mouth. Much 
mucus, especially morning, sometimes with a foul 
taste; thickened in the throat and like glue on the 
tongue ; he desires to wet the mouth. In the morn- 
ing, full of mucus; he has to wash it out; 
disappears after eating. Slimy mouth after waking, 
with pressive headache. It is also diminished, at 
least in so far as sensation goes; the mouth feels 
very dry, with irritable disposition, yet mouth and 
tongue are moist to appearance ; the lips are hot 
and scaly. 

The mucus and saliva are more frequently 



228 



ATROPA BELLADONNA. 



altered ; thus, the saliva becomes tenacious, yellow- 
ish white, coating the tongue, tenacious, thick like 
glue ; he thinks it must smell offensively to others. 
In connection, it may be observed that the orifice 
of Steno's duct is painful as if abraded. 

In the whole mouth and throat dryness, with 
stickiness and great thirst ; the dryness is so great 
it seems to constrict the larynx and fauces, yet he 
can swallow liquids, and in most cases the tongue, 
although feeling as if dry, is really moist. 

It is to be remarked that the tenacious foul and 
foul-smelling slime is found in the mouth chiefly in 
the morning, removed by eating, etc. 

Throat in General. A marked affection. First 
as to the parts affected. 

Fauces in General. Various pains, sensation of 
dryness and burning in the throat and on the 
tongue, not relieved by drinking, but diminished 
for a moment by sugar. Notwithstanding this feel- 
ing of dryness the tongue is moist ; even food and 
drink cause a burning as of alcohol in the mouth. 
(The roof of mouth and palate as if sore and 
excoriated ; painful when touched by tongue and 
when chewing, as if skin were off; and on swal- 
lowing, a scraped feeling as if raw.) 

Tearing on the inner surface of corner of left 
maxilla, in left tonsil and behind it, not affected 
by touch, worse by swallowing. 

Sticking pain in the pharynx, and pain as if 
from internal swelling, felt only when swallowing 
and on turning the head and by feeling the side 



ATROPA BELLADONNA. 



229 



of throat, not during repose or speech ; violent 
sticking on swallowing or breathing. Stickings on 
left side, equally when swallowing and when not 
doing so. 

Scraping, soreness and constriction, with heat 
about the throat. 

An internal swelling is felt, especially on swal- 
lowing and on external touch. 

Throat in general is sore, more on the left side; 
worse on swallowing and spitting ; feeling of in- 
ternal swelling. (499, 500-503, 512, 515-517.) 

Throat feels constricted, violent constriction of 
throat and oesophagus hindering deglutition ; pain- 
ful narrowing and constriction of the throat, with 
tension and straining on every motion like swal- 
lowing, even if nothing is swallowed ; even when 
really swallowing it is not more painful. (516.) 
The feeling of constriction is in itself painful. On 
swallowing, a feeling in the throat as if everything 
were too narrow and constricted so that nothing 
would pass down. 

Tonsils. Fine tearing in the left tonsil, not 
affected by touch, worse by swallowing. (492, 507.) 
Inflammation of the tonsils, going on in four days 
to suppuration ; during these days he could swallow 
nothing. 

CEsophagus. Sensation of constriction, both 
painful in itself and painful on swallowing and 
breathing. (513, 517.) 

Epiglottis. A scratching pain in the region of 
the epiglottis, as if it were raw and sore, following 



23O ATROPA BELLADONNA. 

immediately after a constriction of the oesophagus 
(which constriction is excited chiefly by swallowing.) 

Second, as to the functions particularly modified: 
1. Vegetative. 

Deglutition. Increased activity. There is a con- 
stant inclination to swallow, a feeling as if he would 
suffocate if he did not swallow. 

Difficult, yet painless. This is observed in one 
case. Not so frequent, however, as difficult and 
painful on account of constriction, soreness and 
internal swelling. Difficult to swallow solid food. 
He chews food without swallowing it on account 
of constriction. 

Frequent sticking fingers in throat and feeling 
the neck while unconscious ; and hydrophobia. 
(These symptoms are quoted from allopathic au- 
thorities.) 

When the throat symptoms occur only on one 
side, they prefer the left. 

They occur: 1. Only when swallowing. 2. 
When turning the head. 3. On external pressure. 
4. When breathing deeply. 

They are aggravated by: 1. Touch. 2. Swal- 
lowing. Ameliorated by: 1. Sugar. 2. Repose. 

Taste. The sense of taste may remain natural 
and be diminished in sensibility, as we find to be 
the case ; or its perceptions may be abnormal ; thus 
there is a flat, a putrid, a nauseous taste in the 
mouth ; the saliva tastes as if spoiled ; there is a 
foul taste after having eaten, like taste of spoiled 
meat. A foul taste comes out from the pharynx, as 
well when eating and drinking, although food and 



ATROPA BELLADONNA. 



23I 



drink have their normal taste ; a moderately sweet 
taste; a sticky taste; a saltish sour taste. It is to 
be noted that in part these abnormal phenomena 
depend upon the inflammation of the pharynx, ton- 
sils and salivary glands, which Belladonna evidently 
induces, and which alters their several secretions. 
This alteration is perceptible to the taste, which 
itself is normal. Again it is noticed that, in the 
other case of abnormal taste, the tongue remains 
clean. Evidently, then, the symptoms do not result 
from indigestion (z. e. t the sense of taste, being 
normal, does not perceive the abnormal taste of 
secretions modified by indigestion ; no doubt the 
sense of taste as a nervous function is modified, its 
perceptions distorted.) 

Taste of Food. Food tastes salt; at first it tastes 
right, then, all at once, it tastes partly salt, partly 
tasteless and flat, with a feeling in throat as if it 
did not go down. 

Taste of Bread. Smells and tastes sour, very 
sour; and after eating it, a kind of heart-burn. 
Taste of coffee repugnant. Camphor nauseates. 

Appetite. Many of the phenomena are rather 
nervous than due to organic derangement. 

1. Especial loss. 2. General loss. 3. Gen- 
eral increase. 4. Peculiarities. 

Repugnance to milk ; it has a nauseous smell 
and bitter, sour taste ; lost by continued drinking. 

Repugnance to food. Total repugnance to all 
food and drink, with frequent weak pulse. Repug- 
nance to beer. 

Repugnance to acids, and especially to meat ; 



232 



ATROPA BELLADONNA. 



loss of appetite, entire and long continued ; every- 
thing nauseates, especially after smoking. Loss of 
appetite, with feeling of emptiness and hunger; if 
he begins to eat, everything tastes well and he 
eats as usual. (Again, the loss of appetite is 
rather a nervous phenomenon.) Appetite only for 
bread and soup. 

Increased appetite ( heilwirkung). 

Thirst. Loss of thirst. Entire thirstlessness. 
Abnormal. Greediness to drink, without appetite 
to do so ; he brings the vessel to his lips and then 
sets it down again. Great thirst evening, with 
watery taste, but all drink nauseates him. Great 
thirst for cold drinks, while yet there is no heat 
about the body. Thirst at noon (for several days 
together). 

After Eating. After eating a little, a constricted 
feeling in the stomach ; cough and great thirst ; a 
kind of drunkenness ; pinching below the umbilicus, 
close under the abdominal walls ; bitter eructations. 

After Drinking. After drinking beer, inward 
heat ; after drinking, nausea. 

Gastric Eructations. Frequent eructations, bitter 
and putrid, after eating; these are often incomplete; 
a half hiccough, often a mere vain endeavor ; suc- 
ceeded often by the raising of a burning, sour 
acrid fluid and a kind of straining to vomit, with 
giddiness. (See 526.) The nausea is felt in the 
throat and not in stomach. A burning on the 
upper edge of the larynx, and a biting at the 
upper pharynx. 



ATROPA BELLADONNA. 



233 



Nausea. Nausea felt in throat only. Qualm- 
ishness after breakfast and on going into open 
air; nausea in the stomach, with inclination to 
vomit and great thirst, and with eructations. 

Vomiting. As a rule difficult and scanty ; 
rather a great retching, with sweat. 

Hiccough. A mixture of eructation and hic- 
cough ; hiccough followed by spasm of head and 
extremities ; alternately of right arm and left leg ; 
thirst, redness and heat. 

Epigastrium. Painless throbbing; occasional 
pain, especially a great pressure after eating. 

Stomach. Sensation of pressing is the most 
constant symptom ; violent pressure occurring, for 
the most part, after eating ; or else aggravated by 
eating. It occurs at times only when walk- 
ing, and compels one to go slowly. Fullness 
in pit of stomach and under the short ribs, 
as if gas were pent up there, relieved by 
flatulent emissions, which increase the nausea ; 
on stooping the fullness is greater, with blackness 
before the eyes. Distention, with tensive pain 
evening in bed. The pains are chiefly cramp -like, 
during every meal ; a pain of contraction after a 
moderate meal ; sticking pains in epigastrium, some- 
times so violent as to compel him to bend the 
body backward and hold his breath ; and burning 
felt both in epigastrium and abdomen (these symp- 
toms are doubtful). 

Abdomen. Various pains and sensations in the 
whole abdomen in general (allopathic records) ; 



234 ATROPA BELLADONNA. 

cutting pain. Tensive, spasmodic pain from thorax 
down to hypogastrium, not permitting the least 
motion of the body. Drawing-in pain with press- 
ure, occurring when lying down. Pinching pain, 
compelling one to sit all crouched up and bent for- 
ward, with an unavailing desire for stool and subse- 
quent vomiting ; pinching in the intestines ; pinching 
across the upper abdomen, and down the left side, 
as if in the colon ; pinching, with rumbling. 

Pressure like a stone, together with pain in the 
loins; pressing pain, as from a hard burden, only 
when walking and standing, always relieved by 
sitting. Pinching, clawing, grasping, as if seized 
up with talons, in a spot in the abdomen. 

Distention and rumbling. (See Flatus.) 

Hypochondria. In the hypochondria a pressing 
outward and pain, whenever pressure is made upon 
the epigastrium. 

Distention. Right. Violent constricting pain in 
right hypochondrium, with sharp sticking thence 
through right thorax out to the axilla. 

Pinching cutting, so that he cannot rise from 
his seat. Dull stitches about the last ribs. 

Left. A pressing cutting, when lying quietly 
on the left side, morning, in bed, relieved by lying 
on the other side. 

Umbilical Zone. Various sensations and pains, 
the greater part of which are referred to a region 
immediately below the umbilicus. 

Sensation as if the intestines were pressing out- 
ward, mostly when standing. 



ATROPA BELLADONNA. 



235 



A pressing sticking pain in the umbilical region. 

Constricting pain under the umbilicus, simulta- 
neously with a feeling of distention in the abdomen ; 
the pains come in jerks and double one up. This 
pain compels to crouch forward. Drawing up in a 
knot of the abdomen, as if a coil or lump were 
forming. A most painful grasping together in the 
umbilical region ; it seems to come from the sides 
and concentrate about the navel. 

Dull stickings. 

Right. Violent stickings, as with a dull knife 
between the right hip and the umbilicus. 

Cutting sticking over left hip to loins. 

Hypogastrium. Sensations attributable not only 
to intestines but also to genito-urinary organs. 

Pressing, like a heavy load, very low in hypo- 
gastrium. 

Violent cutting pain, now here now there ; more 
violent on left side. 

Cramp-like, constricting pain in the intestines, 
lying very deep in hypogastrium, alternating with 
dull stitches or jerkings toward perinaeum. 

Violent tensive, pressing pain in whole hypo- 
gastrium, especially in pubic region, as if hypogas- 
trium were spasmodically constricted, sometimes as 
if it were distended (not really so) ; pains which 
gradually increase and gradually diminish. 

Violent pinching deep in hypogastrium, aggra- 
vated by drawing in the hypogastrium and by bend- 
ing the trunk to the left side. 



236 



ATROPA BELLADONNA. 



Loins. Pain, with pressure, as of a stone in 
the abdomen. 

A sticking cutting goes from the umbilical 
region, over the left hip around to the lumbar 
vertebrae, as if in a single stroke, and is more 
painful in the back. 

Flatus. Distention and rumbling. 

External abdomen sensitive. Whole abdomen 
painful, as if raw and sore. 

Heat in abdomen and thorax. 

Itching sticking around navel, better by rubbing. 

Stool. Irritation of various intensity, inducing 
altered secretion and spasmodic action. Sensation 
in the abdomen as if diarrhoea were about to set 
in, with heat in the abdomen. The primary effect 
seems to be the production of a slight diarrhoea ; 
pappy stool mixed with slime ; green stools with 
enuresis and sweat (not inflammatory) ; several 
watery stools immediately after a copious sweat. 
Then the stools become less copious but the irrita- 
tion is increased. At first soft diarrhceic stools, 
then more frequent desire for stool, but very scanty 
evacuations or none at all. Also, desire for stool 
becomes very frequent and violent, inducing strain- 
ing, etc. ; desire for stool, which is thinner but 
normal in quantity ; frequent thin stool with te- 
nesmus ; he must go to stool every quarter of 
an hour ; has to go to stool constantly ; as the 
tenesmus increases the discharge diminishes ; te- 
nesmus ; scanty diarrhceic discharge, followed by 
increased tenesmus ; frequent tenesmus without 



ATROPA BELLADONNA. 



237 



evacuation ; tenesmus without evacuation, followed 
by vomiting. 

Constant tenesmus, a pressing and urging 
toward anus and genitals, alternating with painful 
constriction of anus. 

During stool, a shudder; a kind of chill. 

After stool, increased tenesmus immediately. 

Character of Stool. 1. Consistence, pappy, 
mixed with slime ; diarrhceic, alternating with head- 
ache ; or with nausea and pressure in the stomach ; 
granular, yellow and somewhat slimy ; watery, im- 
mediately after copious sweat ; at first soft and 
diarrhceic, then frequent tenesmus but little or no 
evacuation ; sometimes hard. 2. Color : yellow, 
white, like chalk ; green, with enuresis and sweat. 
3. Smell, sour. 

Rcctttm. Pressing toward the anus ; constrictive 
pain, followed by soreness in the abdomen ; quick, 
slimy diarrhoea and unavailing tenesmus ; single 
stitches. 

Itching, and at the same time constriction sen- 
sation ; itching low in rectum ; violent painful 
itching in rectum and anus ; pleasant tingling in 
lower part. 

Anus. Internal itching, violent, sudden and 
painful. 

External itching when walking in open air. 

Haemorrhage several days in succession from 
haemorrhoidal veins. 

Sphincter relaxation ; involuntary discharges (last 
action in complete intoxication) ; spasmodic con- 



ATROPA BELLADONNA. 



traction. (See under Stool " constriction and con- 
strictive pains.") 

Urinary Organs, i. Pains and sensations. 2. 
Function. 3. Excretions. 

1. Pains and Sensations. Twisting and turning 
in the bladder, as by a great worm, without a 
desire to urinate. Dull pressure in region of blad- 
der. 

2. Function. Discharge suppressed ; the first 
effect seems to be a retention. 

The evacuation is difficult ; occurs only in drops 
(secondary). This symptom is attributed to allo- 
pathic observers. The most striking noted by a 
prover, and probably the first, is frequent desire, 
but evacuation of a very small quantity at a time ; 
the character of the urine is normal, hence the 
effect of the drug has been merely to produce 
spasm. 

Involuntary discharge during sleep and at other 
times; this symptom is noted by Hahnemann as 
well as by allopathists ; it is spasm, perhaps, of 
long fibers. 

Complications. During urination, drawing in 
left seminal cord. After urination, biting in edge 
of prepuce. 

3. Excretions. Urine. Quantity diminished 
according to Hahnemann. 

Increased, according to allopathic authorities. 
Character. Turbid and yellow ; turbid with red 
sediment. (Hahnemann.) 

Color. Yellow and clear ; whitish. White with 



ATROPA BELLADONNA. 239 

white sediment, turbid with red sediment (both 
Hahnemann). 

Genital Organs, r. Pains and sensations gener- 
ally. Violent straining and pressing toward genitals 
as if all would fall out; worse by sitting crooked 
and walking; better by standing and sitting erect. 
Violent stitches in pubic region as if in internal 
genitals. 

Prepuce. Drawn back, with unpleasant sensa- 
tion in exposed glans. 

Urethra. Stitches, length of it, from bulb to 
orifice, while walking. 

Dull stitches behind the glans, especially during 
motion. 

Seminal Cords. Repeated tearing upward in 
left cord, evening in bed before sleeping. 

Drawing during micturition. 

Testes. They are drawn up, with great sticking 
pains in them. 

Semen, i. Nocturnal discharge, from relaxed 
penis. 2. Repeated in one night and without las- 
civious dreams. 

Sexual Instinct. Lost entirely. 
Menses. Before : lassitude, abdominal pain, ano- 
rexia. During : sweat on chest, yawning and 
crawling chills, anxiety about heart, great thirst, 
cramp-like tearing here and there in back and 
arms. Too early and too copious. 

Leucorrhoea. White, after pressing as if all 
would fall out with distention, and then a drawing 
together in abdomen, with abdominal pain. 



24O ATROPA BELLADONNA. 

Respiratory System. Sneezing. Repeated attacks. 

Obstruction of Nose. Nose now obstructed, 
now discharging water. 

Catarrh. With the cough of Belladonna, one- 
sided catarrh with stinking smell like herring-brine, 
especially on blowing the nose. 

Larynx and Trachea. Hoarseness. Voice rough 
and hoarse. 

Cough. The cough is, for the most part, a 
dry, hacking cough, violent, in repeated attacks at 
short intervals ; the violence of the mechanical 
action being apparently out of proportion in its 
intensity to the gravity of the organic affection. 
Spasmodic cough, as if something had fallen into 
the bronchia, or dust had lodged in the larynx. A 
constant inclination to cough. The cough is often 
accompanied by feeling of dryness and tightness in 
the chest and in the upper parts of the air-tubes, 
and is sometimes induced by these sensations. It 
occurs (at noon, once) in the morning, both early 
and after rising ; and at evening after retiring ; 
and on through the night, waking from sleep. It 
is to be observed that it is the spasmodic cough, 
violent, which occurs at night, while the morning 
cough is less violent, and is attended by an 
expectoration of mucus resembling pus (the accu- 
mulation of the night, the affection being in a more 
advanced stage). The aggravation in the evening, 
after lying down, is marked. 

Expectoration. Tenacious saliva, mucus resem- 
bling pus, bloody mucus. 



ATROPA BELLADONNA. 



24I 



Exciting Causes. The cough is excited by the 
slightest irritating cause ; even by every inspiration ; 
by sensation as if he had dust in the throat, or 
something in the bronchia ; by a tickling in the 
back of the larynx (this cough is a violent, dry, 
irritating cough) ; by a tightness in the chest ; by 
a feeling as if something lay at the epigastrium. 

Complications. During the night-cough he 
grinds his teeth. Needle-stickings in the left side 
under the ribs. A violent pressing pain in nape 
of neck as if it would break in pieces. 

Respiration. Difficult and oppressed ; the acts 
of respiration are energetic, small, frequent and 
anxious ; increased difficulty from coffee-drinking ; 
from a pressure in epigastrium. 

Chest. Sensations and pains. Pressing upon 
chest about region of epigastrium, impeding respi- 
ration, whereupon nausea rises up into the throat, 
with faintness ; these alternate. 

A cramp-like constriction in epigastric region 
compelling to breathe deeply, walking. Violent 
constriction as if the chest would be pressed to- 
gether from both sides. Violent constriction not 
relieved by voluntary coughing ; difficult inspiration 
as if hindered by mucus in bronchi ; at same time 
a burning in chest. 

Burning. Heat rises suddenly from abdomen 
in chest, quickly passing away. 

Sticking pains in various parts of the chest, 
brought on and aggravated by coughing, yawning, 
and by motion generally, but not affected by res- 
17 



242 



ATROPA BELLADONNA. 



piration. They occur most frequently on the right 
side, and on that side under the clavicle from 
before backward, under the right arm (checking 
respiration). On left side they occur from sternum 
to axilla. Sticking pains, too, are felt in the ex- 
ternal coverings of the thorax. Pressing pains on 
the cartilages of the left side ; worse on respiration. 
Pressing in the chest and between the scapulae, 
with dyspncea, when walking and sitting. Oppres- 
sion in right chest, causing anxiety. 

Heart. Pains and sensations. Throbbing pain 
and pressing unrest and anxiety. Irregular action. 
A kind of hiccough of the heart on going upstairs. 

External Chest. Eruptions. Painful vesicles 
over .the sternum. Small dark-red spots on chest 
and thighs. On left mamma little scattered pap- 
ules ; itching, relieved by rubbing. 

Mammce. Into the breasts of a woman not 
enceinte, milk enters ; it runs out ; on left mamma 
little scattered papules, relieved by rubbing. 

Pelvic Region Generally. A dull sensitive draw- 
ing in the whole circumference of pelvis ; it goes 
alternately from sacrum to pubes. 

The ischia are painful ; feel as if without flesh ; 
still they feel better when prover sits hard than 
when softly (characteristic). 

In the crest of ilium over the hips a pain as of 
a sharp body cutting out, when he rises from seat. 

Sacrum and Coccyx. In sacrum and coccyx an 
extremely painful cramp-pain ; he can sit only a 
short time; becomes by sitting quite stiff, and can 



ATROPA BELLADONNA. 



243 



then not rise again on account of pain ; cannot even 
lie well, and has to turn to the other side amid 
great pain ; cannot at all lie on his back ; most 
relieved by standing and slowly walking about, but 
quick walking is impossible. 

Loins. Spasmodic sensation in left lumbar 
region. 

Back Generally. Vertebral column: Pains and 
sensations. Pressing pain on the left side under 
the false ribs. Sticking and gnawing pain in 
vertebral column generally ; gnawing pain, with 
cough. Cramp-like, pressing sensation in middle of 
column, which becomes tense on becoming erect. 

Vertebral column and back: Right side, pain as 
if dislocated or sprained. 

Vertebra. Sticking from without inward, as if 
with a knife. 

Scapula. Left: Pressing pain under it, rather 
toward outside. Right: Fine stitches. Between: 
Pain as if from a sprain. Repeated stitches, as if 
electric, from the left to the right scapula. Violent 
drawing between scapulae, down the back. Between 
right and vertebral column, drawing pain ; cramp- 
pain, almost a pinching. 

External Back. Back, and especially the scap- 
ulae, covered with large red papules; whole skin 
looks red and feels sore to touch, but in the points 
of the papules are fine sticking pains. Itching 
eruption on right scapula, tickling on left. 

Nape. Painful stiffness between scapulae and 
in nape, on turning throat and head either way. 



244 ATROPA BELLADONNA. 

Pressing pain externally in neck and throat on 
bending head backward and on touch. 

Externally. Swelling of the glands in the nape, 
with confusion of the head. Papules on nape and 
arm ; fill with pus and form a crust. 

Upper Extremities. Axilla. Left: Painful 
swelling of the glands. 

Arm Generally. Motion: Stretching, twisting 
and turning of upper extremities. Motion convul- 
sive. Spasm of right arm, with gnashing of teeth. 
Jerking in right arm. Drawing down in muscles 
of right arm, and when down a jerking upward 
toward shoulder. Convulsive shuddering. Tonic 
spasm (allopathic observations). 

Sensation. Lassitude, especially in hands, which 
he leaves hanging down. Heaviness and paralysis, 
especially of left arm. Paralytic pressure and par- 
alytic sensation and weakness in left arm. 

Pains. Tearing pain, as if too short; stiffness; 
tearing pains ; drawing pains ; pains as if beaten. 

Externally. Sensation : Crawling, as of a fly, 
not relieved by rubbing. 

Eruptio7i. Papule under each elbow, dull red, 
no sensation nor suppuration. 

Elbow. Rumbling ( Kollern ) as of water or 
blood running through the veins. Pains. Cutting 
pains inwardly, when walking. Sharp stitches 
externally. Paralytic drawing pains in elbow and 
in fingers of left hand. 

Forearm. Fine stitches in left forearm. Dull 
sticking in middle of inner forearm, becoming 



ATROPA BELLADONNA. 245 

gradually worse and at last very violent. Cutting 
tearing pain. 

Carpus. Paralytic tearing in the carpal bones. 

Metacarpus. Sticking tearing in the bone of 
left metacarpus. 

Hands Generally. Copious cold sweat; swell- 
ing; painless stiffness, hindering flexion as if joints 
were dry. 

Fingers. Painful drawing in periosteum. Tear- 
ing cutting. 

Externally. Little red spots on dorsa, vanishing 
quickly. Finger, vesicle with painful inflammation. 
Pustule close to nail. 

Lower Extremities Generally. Motion : Stretch- 
ing, he is obliged to extend the limb. Paralysis 
with nausea, trembling anxiety (from allopathic 
authorities). 

Sensations. Soreness on inside of limb ; sensa- 
tion as if beaten or rotten in whole limb, with 
sticking and gnawing in the bones, with great 
tearing in the joints ; this gradually rises from the 
feet to the hip, relieved by motion and walking ; 
weariness and heaviness of the limbs a marked 
symptom, with drawing pain, a paralytic sensation. 

Iliac Region and Joint. Cramp pain with 
tension in the glutsei when stooping. In the hip- 
joint (right) a cold feeling ; transient, sticking pain 
both during rest and motion; paralytic tension 
when walking, as if luxated. Left : Pain with limp- 
ing (allopathic), also nervous. Right : Pain when 
lying on it, relieved by turning to lie on left hip. 



246 



ATROPA BELLADONNA. 



Thigh. Excessive heaviness and stiffness 
when walking ; heaviness when sitting ; sticking 
pain, as from a knife in middle of thigh, 
rather behind (after dinner) ; sticking cutting 
in exterior muscles of right thigh, just above the 
knee, only when sitting; cutting, jerking tearing in 
posterior muscles of left thigh when sitting; draw- 
ing pain outward toward skin at a small spot inside 
left thigh ; throbbing spot inside of left thigh. 

Knee. Violent pains ; unpleasant sensations, 
especially in knee and in other joints of lower 
extremities, as if they would " click" when walking 
and descending. 

Above. Tingling, quivering sensation when sit- 
ting. 

Patella. Right : Cramp pain near patella, from 
within outward ; sitting, pressing sticking while 
sitting. Left: Needle stickings under patella, sitting. 

Hollow. Motion : Stiffness on motion, as if 
external (and sometimes the internal) hamstrings 
were too short; in thigh muscles, jerking upward 
and pains: Right: Squeezing and pressing pains. 
Left: Dull sticking. 

Leg Generally. Motion: Has to stretch out 
the foot from horrid pain in leg. 

Sensations. Paralytic lassitude in both legs, 
and especially in calves on going upstairs; trem- 
bling heaviness of right leg when it is crossed over 
the left; a drawing-up sensation, which is externally 
a mere crawling, but internally is innumerable 
stitches. 



ATROPA BELLADONNA. 



247 



Legs.' Pains: Stitches, painful from foot to knee 
(when stepping with left foot) ; cutting drawing, 
first in a little spot on the feet, then through the 
leg and thigh to the loins and shoulder; com- 
pressed and dull tearing, especially at night, 
relieved by hanging the leg cut cf bed ; a dull 
burning tearing up the leg through the inner 
hamstring. 

Shin. Tearing in shin-bone ; in right shin- 
bone, with pressing asunder sensation. Left: Press- 
ing' when standing. 

Calf. Left: Sharp sticking from below upward; 
cramp on bending the leg, evening in bed, relieved 
by stretching out the thigh ; tearing pain inside, 
not affected by motion or touch. 

Feet. Externally. Sweat without warmth ; 
excoriating itching, soles and dorsa ; itching, swell- 
ing of the feet. 

Sensations, ydnts. Right : Tension on walk- 
ing ; pain in metatarsus, as if luxated on walking 
and bending inward the sole ; tearing in the great 
toe joint. 

Sole. Cramp, evening in bed on bending up 
the knee ; burning and digging. 

Pains. Dorsa. Dull stickings when sitting, 
not affected by external pressure. 

Soles. Heat; boring digging pains. 

Heel. Tension in right sole in the region of 
the heel, becoming a tensive pressure, relieved for 
a while by pressure. 

Tendo A chillis. Boring or tearing sticking. 



248 ATROPA BELLADONNA. 

Generalities. Motion : Constant disposition to 
stretch, evening ; pain prevents it. 

Pain advances gradually to a very high pitch ; 
then suddenly vanishes and re-appears in another 
spot ; sudden horrid pain in one side of chest, 
abdomen, loins or in one elbow, especially during 
sleep, compelling to crook the part. 

Aggravations. All symptoms aggravated after- 
noon (three and four p. m.) ; more tolerable 
forenoon ; gnawing pain in affected parts. 

Sensitive to touch ; parts where sticking 
pains have been are very sore ; crawling, tearing, 
sticking, itching, here and there, in evening in bed; 
after rubbing a tearing pain remains. 

Glands. Boring pain in the affected glands. 

Skin. Ulcers. Burning pain, almost only at 
night (six p. m. to six a. m.), as if something 
would be pressed out; the parts as if lame and 
stiff; violent itching; cutting pain during rest, 
tearing during motion of the part ; soreness around 
ulcer. 

Discharge almost nothing but bloody serum. 

Spasm. Spasmodic laughter; convulsive move- 
ments of the extremities, subsultus tendinnm, etc., 
are attributed to Belladonna by allopathic authorities. 
Slight vexation induces convulsive paroxysms ; he 
inclines to run up the walls ; convulsive movements 
on waking. 

Under title Sleep, frequent mention will be 
made of convulsive motion on waking and during 
sleep. 



ATROPA BELLADONNA. 



249 



Restlessness. He has constantly to change the 
position of limbs and body, especially hands and 
feet; trembling in all his limbs. 

Lassitude. Disinclination to work; lassitude 
generally, and in morning after a sleep, whether 
long and heavy or interrupted by dreams, forgotten 
or not; feebleness of hands and feet; uncertain 
step, the knees give way. 

Paralysis. Paralytic weakness of all limbs, 
especially of the feet. Allopathic authors quote 
complete paralysis of left side, arm and thigh; 
stiffness and paralysis of the extremities and whole 
body. 

Syncope. Complete. Allopaths quote an entire 
apoplectic condition. 

Sleep. Sleepiness ; stupidity compelling sleep, 
which lasts about ninety minutes; after it great 
hunger, with great burning heat in mouth ; no 
thirst; foul breath on coughing; great sleepiness 
with yawning; afternoon, sleepiness with yawning 
and stretching, and eyes filled with water; sleepi- 
ness at night, with inability to sleep, or starting 
up in a fright at the moment of falling asleep. 

Going to Sleep. Starting up in a fright, the 
feet jerking upward and the head forward; always, 
on going to sleep, waking and starting with fright. 
Just at time when he usually goes to sleep he lies 
long without knowing whether he is awake or is 
dreaming; in evening it seems as if the bed swims. 

Time. Generally late; sometimes early, and, 
waking early, refreshed for time only. 



250 



ATROPA BELLADONNA. 



Sleep. Restless sleep before midnight, tossing 
and talking in the sleep ; restless, being full of 
dreams about men or about business ; restless, the 
pains become unendurable, with frightful dreams; 
restless, he wakes frequently, tossing and cannot 
sleep again; heavy, with anxious dreams which he 
cannot recall; he even hears himself cry out from 
fright and yet does not awake; when waked by 
coughing, he goes to sleep again immediately, yet 
in the morning is unrefreshed, with lassitude. 
During sleep, starting continually; singing and loud 
speaking. 

Complication. Whether asleep or awake, inter- 
ruption of the respiration; the respiratory act lasts 
only half as long as the pause; expiration follows 
suddenly and convulsively, and is louder than 
inspiration; inspiration only a little longer than 
expiration. 

Dreams. Many dreams about men and business; 
many which are not remembered, they take the 
refreshment from sleep; not many until toward 
morning. Character: Lively dreams; fearful, waking 
him with starting and a cry of murder and robbers; 
dreams with aggravation of the pains. 

Waking during sleep; he awakes full of alarm 
and fear, as if something under the bed had cried 
out, with dry heat; waking, with fearful dreams, 
with sweat on forehead and prsecordia. 

Waking morning ; bad humor, headache and las- 
situde ; headache over the eyes, like a weight in the 
head, and pain in the eyes when touched; sleepiness. 



ATROPA BELLADONNA. ' 25 1 

Sleeplessness. Great sleeplessness for several 
nights in succession, from anxiety, with drawing 
pains in the limbs; sleeplessness from phantasies 
which hold her attention. 

Fever. Allopathic authorities mention paroxysms 
of fever, commencing generally in the night after 
midnight or in the morning, accompanied by very 
great thirst, which is greatest after the sweat. The 
sweat is copious. 

(11 78-1 194.) Hahnemann also describes par- 
oxysms: These occur in the afternoon or evening; 
very severe chill; two hours after, heat and general 
sweat, without thirst during either chill or heat; 
the heat is especially great about the head and in 
the face, and is often attended by dizziness; fre- 
quent attacks of fever during the day; chill, 
followed by general heat and sweat, without thirst 
during either stage. 

Chill. Paleness and coldness; ice-cold hands, 
dull headache and depression; coldness of the whole 
body, especially of the feet (with headache, congestio 
ad caput J, with swollen, red face and hot head, 
pain in ears, etc.; cold, beginning in the back and 
epigastrium or in both arms, and going over the 
whole body. 

Shudder in various parts, with heat in others; 
with heat in ears and head and face and nose; 
swollen face. 

Sweat of feet. 

Chill excited by every breath of air, yet air, in 
other respects, is agreeable. • > 



252 



ATROPA BELLADONNA. 



Heat. Allopathic authors mention violent burn- 
ing heat, both internal and external; red face; 
general dry heat of feet and hands, without thirst; 
pale face. 

Internal Heat. Everything taken is too cold. 

Internal heat with swollen veins, and especially 
pulsation of the carotids so great as to make the 
teeth chatter ; heat in head. 

Internal heat morning in bed, yet he does not 
uncover ; pain in the parts which he does uncover, 
as if from cold. 

Internal heat and external over whole body, espe- 
cially the head ; pulsation in the temporal arteries, 
with confusion in the head and subsequent sweat. 

Internal heat both sensible and actual, especially 
in red, sweaty face, with headache and thirst. 

Heat. Excited by slight motion. 

In Relation to External Surface. Allopathic 
authors quote : Inflammation of whole body, with 
quick pulse ; heat of the whole body, with violent 
redness ; redness and swelling of whole body ; 
burning hot and red, with pricking, biting sensa- 
tion ; itching of the whole body, with eruption of 
red petecchiae. 

Eruptive Fevers. Thorax and abdomen covered 
with little red, elevated, painless spots, which often 
vanish and suddenly re-appear, with general redness 
of the skin. Inflamed red spots and spots like 
scarlatina, of various forms, over the body. Hot 
erysipelatoid fever, accompanied by swellings in- 
flamed and even gangrenous. 



ATROPA BELLADONNA. 



253 



Allopathic authors in addition give : Blood-red 
spots on the whole body, especially in the face and 
chest. Measles-like eruption. Dull, red, scarlet- 
fever-like spots over the whole body, with small, 
quick pulse, dyspnoea, violent cough, delirium, in- 
creased memory and dilated pupils. 

Sweat. Sweat more or less copious after the 
heat. Fugitive sweats, alternating with coolness ; 
sometimes occurring with heat. The sweat is most 
apt to occur, or is most copious, on face and fore- 
head, and is often unaccompanied by thirst. » 

Excited by : Slight motion during sleep ; many 
symptoms refer to night-sweats, very copious ; cov- 
ering one's self in bed, only the parts covered sweat ; 
covering the hands in bed, inducing a general 
sweat ; on uncovering them, a general chill. 

Time. Night frequently mentioned. The night- 
sweat does not debilitate. Immediately after mid- 
night. During sleep. Morning. 
Smell. The night-sweat putrid. 
Pulse. Strong and frequent, large, full and 
slow. Small and frequent. Large, 85. 

A nxiety. Crying out on the slightest provoca- 
tion, on approach of anybody. During the day, 
no rest in any place. Great affright. Anxiety in 
the precordial region. 

Groaning. Frequent, especially in morning, 
without knowing why. At every expiration, and 
during sleep. 

Allopathic authors give : Trembling in hands 
and feet, with sudden cry. Anxiety, followed by 



254 ATROPA BELLADONNA. 

sweat, about things formerly hoped for. Anxiety 
and unrest in praecordia, with headache, red face 
and bitter taste. 

Restless7iess. Cannot sit long in one spot, goes 
about everywhere. Ceaseless motion of the body, 
especially the arms ; pulse not being altered. Con- 
stant tossing in bed. 

Delirium. Allopathic authors give: Speech with- 
out connection. Constant delirium, waking and in 
dreams. It comes on after eating. Dreams of con- 
flagration at home, of wolves and dogs around him. 

Night — delirium, with consciousness during the 
day. Paroxysms of delirium. 

(F. Hahnemann.) She sits idle behind the 
stove ; makes songs and sings them, senseless and 
incoherent ; also she whistles by times ; eats and 
drinks nothing ; pale face and sweat on the fore- 
head. 

Disposition. Elevated. Shown by disposition 
to sing and whistle ; laughing at she knows not 
what ; frequent laughing and singing, loud and 
long ; laughable gestures, now sitting, now motion- 
ing as if washing, counting money, drinking. 

Allopathic authors give : Great insane excite- 
ment ; running half-clad, with wonderful gestures ; 
laughing, singing, dancing, etc. ; violent shaking of 
the head, foaming at the mouth ; clapping the 
hands over the head, saliva running out of the 
mouth ; she distorts her face ; her tongue hangs 
out of her mouth. 

Depressed. Anxiety with weeping ; she is tired 



ATROPA BELLADONNA. 255 

of life. Fearfulness, with disposition to weep. 
Whining, sniffling and howling without cause, with 
fearfulness especially on waking. Indifference. In- 
activity of mind and body. 

Indifferent to everything; careless of life. Ap- 
athetic, unimpressiblc. Then, after a few days, she 
is very sensitive and impressible. 

Irritable. Irritability about trifles, with pressing 
headache as from a stone, caused by every noise 
or visit. She wishes solitude and repose. Quiet 
irritability, alternating with the natural disposition, 
with great dryness in the mouth. 

Anger. If all be not right, even anger at him- 
self about very trifles. 

Irritability and over-sensibility; all the senses are 
too highly strung. 

Rage. Either paroxysmal or constant delirium; 
first jolly, then raging; howling and crying about 
trifles, aggravated by kind speeches; with very 
mobile pupils; violent rage, not to be soothed. 

Allopathic authors give : Rage, tossing about in 
bed, tearing clothes, striking himself in the face 
with his fist, gnashing of the teeth and convulsions ; 
biting the spoon, barking and howling ; great desire 
to bite the by-standers. This rage is attended by 
burning heat of the body, open, staring eyes, and 
spitting at the by-standers. 

Mistrust and desire to flee; fear of an imaginary 
black dog. This is in general a primary and early 
effect of Belladonna. She seeks to flee; asks her 
friends to kill her; throws herself into the water. 



256 



ATROPA BELLADONNA. 



PRACTICAL APPLICATIONS. 

The practical scope of Belladonna in therapeu- 
tics may be inferred from a resume of its physio- 
logical action. 

We have seen that it acts upon every part of 
the nervous system ; upon the sensorium, producing 
confusion, delirium, mania, stupor; that simulta- 
neously it produces heat of the head, redness of 
the face and eyes, throbbing of the carotids, a full, 
hard and tolerably frequent pulse, together with 
perversions of the special senses and spasmodic 
action of the voluntary muscles. 

Now, these symptoms point to the use of Bel- 
ladonna in diseases which involve not merely the 
function, but also the tissues, of the nervous center 
of the cerebro-spinal nervous system. Accordingly, 
in mania we find Belladonna a prominent remedy, 
as likewise in inflammation of the brain and its 
meninges. In these affections, besides the perver- 
sion of the sensorial functions and the direct 
symptoms of cerebritis or meningitis respect- 
ively, there will always be present, if Belladonna 
be indicated, the red face, shining eyes and full, 
hard pulse, already described. These may not be 
present along with mania. The face may be of a 
natural hue or pale; the pulse not fuller, even 
smaller, than is customary; the expression, far from 
being anxious, turgid, inflammatory, may be mild 
or pinched, or again, stupid. In such cases, the 
true remedy may be Hyoscyamus, Stramonium, 



ATROPA BELLADONNA. 257 

Veratrum, Platina or Natrum muriaticum or some 
other drug; it cannot be Belladonna. 

So of the encephalitis, the face may be pale, 
the eyes dull or distorted, the patient stupid or 
nearly so, the pulse slow and soft. The brain or 
its membranes, or both, may indeed be the seat of 
inflammation, but Belladonna cannot be the remedy. 
This may be Helleborus niger or Sulphur or Bryo- 
nia or Zincum. 

As a generalization, it may be stated that Bel- 
ladonna seems to be required in cases in which 
the arterial storm which would have indicated 
Aconite, having actually burst upon the patient and 
localized its action in the encephalon, this localiza- 
tion is still in the first stage of engorgement and 
plastic deposit. When the period of serous effusion 
arrives, or when the deposit is complete, the case 
has already passed beyond the province of Bella- 
donna; and now Hellebore, Sulphur and Zinc come 
into the field. 

In affections of the eye, both functional and 

organic, Belladonna is indicated by the symptoms, 

and has approved itself in practice. As regards 

functional disease, cases are numerous in which 

partial or total blindness has ensued from poisoning 

with Belladonna. On the other hand, Belladonna 

has approved itself a frequently indicated and very 

serviceable remedy in amaurosis, partial or complete. 

As to organic affections, while the conjunctiva 

and the secretions are but moderately affected, the 

deeper tissues of the eyes seem to be gravely 
18 



ATROPA BELLADONNA. 



attacked, as is shown by the deep pains in the 
orbits, the fullness and distention of the eye as 
though it would burst, the supra-orbital and post- 
orbital pains and the illusions of vision. It is rarely 
that Belladonna is indicated, unless the general 
symptoms characteristic of its action are present, 
viz., the full, hard pulse, the red and hot face, the 
frontal weight and heat and the peculiar crescendo 
character of the pain. 

The facial neuralgia produced by Belladonna 
has been fully described. Many cases of cure are 
recorded. The pain has the peculiarities already 
described, and is most likely to be aggravated in 
the evening. It occurs generally on the right side, 
and is thus distinguished from the neuralgia for 
which Spigelia is indicated. From the neuralgia 
which requires Stannum, and which may also be on 
the right side, it is distinguished by the fact that 
the pain which Stannum produces and relieves 
comes on gently, increases gradually and then as 
gradually diminishes in severity; while that of Bel- 
ladonna, after gradually rising to an intolerable 
acuteness, ceases on a sudden. 

Inflammatory affections of the throat can hardly 
be mentioned in any connection without calling to 
mind Belladonna as a remedy, so universal is its 
use and so efficacious. In simple tonsillitis, when 
the tonsils are swollen and present a bright red 
appearance with painful and difficult deglutition, at 
first dryness of the fauces, and then moderate 
secretion of ropy mucus or saliva, with the charac- 



ATROPA BELLADONNA. 



259 



teristic pulse and expression of face, Belladonna 
suffices to effect a cure in a few hours. It is useful 
not merely in tonsillitis, but equally so in pharyn- 
gitis, in inflammation of the soft palate and uvula, 
and of the larynx when the mucous membrane and 
the sub-mucous cellular tissue are both involved. 
The redness is vivid ; the pain is acute, tense and 
often throbbing; the arterial action very decided. 
The secretion of the mucous membrane in a 
typical Belladonna case, though it may be dimin- 
ished causing dryness, or thickened causing a ropy 
discharge, is not altered in such wise as to simu- 
late a plastic or a diphtheritic deposit. In such 
cases the remedy is more likely to be found 
among Mercury, Bromine, Cantharis, Muriatic acid 
and Lachesis. 

If, again, the affection of the sub-mucous cellular 
tissue be such as to cause a dropsical effusion into 
this tissue, so that the soft curtain of the palate, 
the uvula and the walls of the pharynx become like 
swollen, translucent water-bags, Belladonna is not 
indicated. The remedy is Rhus or possibly Phos- 
phorus. 

Finally, the tonsils may be chronically enlarged. 
The fissures may be very prominent. In these 
fissures little white granules are observed, which 
are very fetid and are oily in their composition. 

The swelling of the tonsil is very evident ex- 
ternally, and is painful on external pressure. 

Pathologists are not agreed as to the nature 
and origin of these white granules. I believe them 



260 



ATROPA BELLADONNA. 



to be the altered secretion of the tonsil. Such a 
state of things is generally attended by follicular 
pharyngitis and by cough, loss of voice and accu- 
mulations of mucus in the larynx and trachea. In 
such cases Lachesis is almost always indicated. 
None of these are Belladonna cases, and the sooner 
their nature is discovered and the true remedy 
given in place of Belladonna, which may have been 
at first selected, the better for the patient. 

Finally, in a case which was, or seemed to be, 
a Belladonna case, the swelling increases, the diffi- 
culty in swallowing becomes very great, the mucous 
membrane of the fauces grows livid, a sharp stick- 
ing pain as from a splinter is felt in the side of the 
fauces, the external swelling is great and tender, 
the secretion becomes offensive and yellowish, the 
pulse becomes frequent, but softer and smaller ; 
in fact, it is evident that an abscess is forming 
in the substance of the tonsil. In such a case 
Belladonna will do no good. Hepar sulphuris will 
be more likely to arrest suppuration if that be 
possible, 'or else to circumscribe and hasten it, if 
the case have already gone so far that resolution is 
impossible. 

Of the peculiar throat affection of scarlatina 
more will be said when we come to speak of that 
disease. 

On the digestive apparatus, on the function of 
nutrition, as already stated, Belladonna exerts but 
little action. It is rarely indicated in diseases of 
this apparatus. Nevertheless the general symptoms 



ATROPA BELLADONNA. 



26l 



characteristic of Belladonna may be present in so 
marked a degree in some disease of these organs 
as to call for Belladonna. Thus, in acute hepatitis 
it may possibly be sometimes called for, not so 
much by the liver symptoms as by the general 
subjective or objective sympathetic symptoms affect- 
ing other organs or systems. 

Belladonna may perhaps be indicated in some 
forms of dysentery, or of inflammation of the rec- 
tum, as the symptoms of "constant tenesmus and 
pressing downward upon both bladder and rectum, 
with scanty stool and increased tenesmus following 
the stool," show. Yet the drug does not corre- 
spond to the general character of these diseases, 
and if indicated it will be so rather by virtue of 
its general characteristics ; and although it may be 
an indispensable remedy at some other stage of a 
difficult case, it will rarely prove the sole and all- 
sufficient cure for any case of dysentery. 

The urine, as we have seen, is scanty, with 
frequent tenesmus of the bladder and slight stran- 
gury. The urine itself is dark and turbid, and 
sometimes fiery red. 

Belladonna has been frequently used in inflam- 
matory affections of the bladder, attended by the. 
above symptoms and by the general characteristics 
of Belladonna. Likewise, in the first stage of 
desquamative nephritis. 

Its appropriateness to this frequent feature of 
scarlatina is an additional item in the indication of 
Belladonna for that disease. 



262 



ATROPA BELLADONNA. 



In its applicability to these affections, Belladonna 
is associated with Cantharides, Apis, Terebinth, 
Arsenicum and Mercury. 

If we are at all in a position to draw distinc- 
tions between the members of this group, I should 
say that Cantharides corresponds more particularly 
to affections of the bladder and urethra, and not 
of the kidney; Belladonna to those of the bladder, 
especially its neck, and to the first stage of kidney 
affection, congestion ; Terebinth to the kidney and 
not to the bladder, and to the first stage of the 
kidney affection, that of congestion and hematuria 
before albumen is effused; Mercury to the kidney 
when albumen is being effused, but before dropsy 
occurs; Apis and Arsenicum to the kidney and to 
the second stage when albumen in abundance is 
effused, and when, in addition, the disease has 
endured so long that dropsical effusions have 
occurred in the cellular tissue. I cannot give these 
distinctions authoritatively. They should not influ- 
ence your prescriptions, unless the other and 
general symptoms of each case correspond to those 
of the drug; I believe in most cases they will be 
found to correspond. 

The symptoms of Belladonna which relate to 
the pelvic organs, and in particular to the uterus, 
are very graphic. No remedy is more frequently 
and successfully employed for affections of the 
genital organs of women. 

On the provers, Belladonna produced the symp- 
tom: " Constant and violent pressure downward 



ATROPA BELLADONNA. 



263 



toward the genital organs, as if everything would 
fall out." 

This symptom would suggest the use of Bella- 
donna in cases of prolapsus uteri, whether chronic 
and constant, or occurring at intervals, or at the 
menstrual period in case of dysmenorrhcea. 

In all of these cases, Belladonna is one of our 
most valuable remedies. But four other drugs of 
the "Materia Medica Pura" have the very same 
symptom, viz. : Sepia, Nux vomica, Podophyllum 
and Pulsatilla. 

How shall we distinguish the case appropriate 
for each remedy? Why, by the conditions and the 
concomitant symptoms. 

The above symptom of Belladonna is worse 
when the patient sits bent over and when she 
walks, but is better when she sits erect or when 
she stands. Now, under Sepia, the conditions are 
just the reverse; the symptom is aggravated by 
sitting up, still more by standing, and most of all 
by walking; while it is relieved by lying down; 
just what you would expect in a case of atonic 
relaxation of the ligamentous and vaginal supports 
of the uterus; while the apparent incongruities of 
the Belladonna conditions accord well with the 
conditions of an irritable or inflammatory state of 
the organ. 

Nux vomica, again, has the pressing down 
more in the back, with irritable rectum, frequent 
ineffectual desire for stool, with scanty evacuations. 
There is but little leucorrhcea. Pulsatilla, on the 



264 



ATROPA BELLADONNA. 



other hand, has the same symptom as Belladonna, 
with aggravation on lying down, but it has also 
aggravation from heat, and amelioration in the 
open air, with pressure on the bladder and frequent 
micturition; but this is copious and not attended 
by strangury. 

Moreover, there is a copious thick leucorrhcea. 
The general symptoms show a disposition to a 
hydraemic condition, instead of the hyperaemia or 
hyperrhinosis of Belladonna. 

Podophyllum has not been so carefully proved 
as to furnish a good idea of its characteristics. But 
I believe that it is rarely useful in prolapsus, unless 
there be also prolapsus of the vagina and rectum, 
or a tendency thereto, and pain in the region of 
the ovaries. 

There is a form of dysmenorrhcea in which 
Belladonna is capable of effecting a radical cure, 
even in cases of many years' standing. The pain 
is often exceedingly severe, driving the patient to 
the use of anodynes. It is a dragging and press- 
ing downward. There are also cutting pains from 
behind forward, or vice versa, and passing through 
a horizontal diameter of the pelvis, and not around 
its circumference (as the pains of Sepia and Platina 
do). These pains precede the appearance of the 
menses from six to twenty hours. They are parox- 
ysmal and intolerable. The patient notices that an 
evacuation of the bowels at this time is painful. 

It seems as though the faeces, particularly if the 
mass be large and tolerably solid, in passing along 



ATROPA BELLADONNA. 



265 



the rectum, pressed anteriorly upon a sore surface. 
If the index finger be passed into the rectum, a 
hot rounded tumor may be perceived about two 
and one-half inches above the orifice of the rectum. 
It is extremely painful when gently pressed. A 
vaginal examination brings the finger in contact 
with this same body in the posterior cul de sac of 
the vagina. It is the congested or inflamed ovary. 
In very severe cases of this kind, I have found 
that Belladonna, persisted in for many consecutive 
months, given just before each menstrual epoch, 
would suffice to overcome at least all tendency to 
a recurrence of these attacks, and would render 
menstruation normal. 

Belladonna has been successfully used in certain 
cases of uterine haemorrhage. 

While on this subject I may call your attention 
to a singular affection, the pathology of which I 
do not understand. 

In women apparently healthy, in whom the 
function of menstruation is in every other respect 
normal, the flow is sometimes extremely offensive. 
It has been described to me by the patients and 
their friends as peculiarly and distressingly offen- 
sive. The peculiar character of this odor I could 
never get intelligibly described. The cases that 
have come under my observation have been un- 
married young women, in good circumstances and 
of most exemplary habits in every way. I was led 
to give Belladonna from the symptom (quoted by 
I iahnemann from Evers' "Berliner Sammlungen," iv.) 



266 



ATROPA BELLADONNA. 



"offensive metrorrhagia." The oclor ceased to be 
perceived. No other remedy or treatment had any 
effect. A similar odor has been observed in the 
lochial discharge on the fourth or fifth day, and has 
likewise been removed by Belladonna. 

Belladonna has been recommended by allopathic 
physicians during labor, as a local remedy for 
rigidity of the os uteri. Cases not infrequently 
occur during labor, or during the puerperal period, 
in which the general symptoms characteristic of 
Belladonna are present, and indicate that remedy. 

In affections of the respiratory organs Bella- 
donna is a most important remedy ; but especially 
in irritable and inflammatory conditions of the 
larynx and trachea, whether isolated or conjoined 
with the affections of the fauces and the pharynx 
already described. 

The cough is dry, or, if there be any sputa, it 
is only after long coughing, and they consist often 
of mucus tinged with blood. It occurs, or is much 
aggravated, in the evening and early night — more 
particularly just after lying down. 

It comes in paroxysms. 

It is accompanied by heat and great redness of 
the face, sparkling eyes and full, hard pulse. It is 
provoked by a tickling in the larynx, as if dust 
were there, in the back part of the larynx, which 
compels a hard, dry cough. 

It is induced by exertion, by lying down and by 
very deep inspiration. 

It is accompanied by a feeling of soreness in 



ATROPA BELLADONNA. 



267 



the larynx, as if internally hot and sore ; this sore- 
ness is felt when pressing the larynx externally. 
It is also accompanied by oppression of the chest, 
heat in the chest, dyspnoea, etc. 

These symptoms have led to the use of Bella- 
donna in laryngitis of adults, and in the first stages 
of croup ; in certain epidemics, in trachitis, and in 
pneumonia. The general symptoms must corre- 
spond, as always. 

It is of the greatest importance to distinguish 
the cough of Belladonna from those of its cognates, 
viz., Lachesis, Phosphorus, Causticum, Rumex cris- 
pus and Cepa. I will sketch their characteristics 
now, and repeat them as we take up each remedy, 
hoping by reiteration to fix them in your minds. 

The cough of Lachesis is dry, like that of Bel- 
ladonna; but there is a sensation as if something 
were in the trachea which might be raised, and 
indeed comes partly up, but then goes back again. 

It is provoked by tickling in the trachea (below 
that of Belladonna) induced by touching the trachea 
or pressing on it, or by pressure of the clothing of 
the patient, and which he therefore loosens, or by 
throwing the head back, and also by eating. 

It occurs always on awaking from sleep. 

It is accompanied by some hoarseness and sore 
throat, which shoots up into the ear, and by chronic 
tonsillitis, with oily white granules. 

The cough of Phosphorus is dry, or has a scanty, 
rusty sputum. It occurs night or day. It is pro- 
voked by a tickling in the trachea pretty low down, 



268 



ATROPA BELLADONNA. 



and by a feeling of rawness and soreness in the 
trachea and bronchi. It is induced by a very deep 
inspiration. It is accompanied and characterized 
by a hoarse, barking sound, by rawness of trachea 
and whole chest, and by a peculiar and distressing 
weight across the chest. Hoarseness. 

The cough of Causticum is dry. It occurs in 
the evening. It is provoked by a tickling high in 
the trachea. It is in long paroxysms. The voice 
is almost gone. The trachea is sore and raw, but 
not the chest. 

The cough of Rumex crispus is dry and short 
and paroxysmal, or is a constant hack. It occurs 
evening and night on going to bed. It is provoked 
by tickling in the supra-sternal fossa ; is induced 
by pressure in that region ; is induced by inhaling 
a breath of cool air ; by a deep inhalation ; by any 
variation of breathing. It is accompanied by great 
fatigue from coughing, and by stitches through the 
left lung. 

The cough of Cepa is dry, though there are 
acrid coryza and lachrymation. The cough is 
induced by tickling in the larynx, and each cough 
feels as though it would split the larynx in two. 
The patient cringes under the pain. 

I have traveled out of my record to give 
these characteristics of the cough of each member 
of this group and to compare them, because this 
sharp discrimination it is the business of the 
practitioner to make whenever he is called upon 
to prescribe for a patient; and my chief business 



ATROPA BELLADONNA. 



269 



is to show you what is to be done and how to 

do it, so that the great object may be best attained, 

viz., the selection of the right remedy and the 
cure of the patient. 

GENERAL DISEASES. 

Passing now from the application of Belladonna 
to diseases of special organs or apparatus, we 
come to its use in general diseases of the entire 
system; and first, in 

Fevers. In intermittent fever we should not be 
likely to select Belladonna. Its proving shows hardly 
a trace of periodicity, neither is the febrile paroxysm 
distinctly divided into stages. For this very reason, 
however, it may be required in some malarious 
diseases, commonly classed among intermittents, 
and in which the heat begins early and is nearly 
continuous, and the head shows signs from the first 
of being involved; great cerebral congestion or 
positive inflammation taking place in the encepha- 
lon. In such cases, Belladonna may be indicated. 
The characteristic general symptom will be present. 
The fever of the Roman Campagna is of this kind. 

In typhoid or typhus fever, we should not 
expect to employ Belladonna save as an intercurrent 
remedy. Its symptoms give us no picture of 
blood decomposition. The nervous system, instead 
of being depressed, unstrung or suspended from its 
office, is stimulated, aroused; and if perverted in 
its action, perverted through the morbid intensity 
and energy of that action. 



270 ATROPA BELLADONNA. 

All this is very unlike the effect of the typhus 
miasm on the nervous system. 

Nor, again, does Belladonna present us the 
muscular torpor and paralysis peculiar to typhus, 
and which Rhus toxicodendron and Arsenicum 
present so clearly. 

Belladonna, then, is not suited to a typical case 
of typhus or typhoid. 

Nevertheless, cases may occur that will call for 
it. Mania, per se, or encephalitis, may occur in 
the course of the disease, and, presenting the char- 
acteristic symptoms of Belladonna, may require its 
use as an intercurrent, but as an intercurrent only. 

And let me warn you to beware of intercurrent 
remedies. Let your aim be to select each drug 
as a remedy corresponding not merely to the 
present symptoms, but also to that general charac- 
ter and fabric of the disease which determine its 
symptoms and their successive productions, course 
and relations. 

Eruptive Fevers. While Belladonna 'may be 
indicated' by the totality of the symptoms at some 
period during the course of any one of the eruptive 
fevers, it is particularly to scarlatina that it seems 
closely to correspond, and in the treatment as well 
as in the prevention of which it has become a 
famous remedy. 

Prophylaxis. Hahnemann's attention was called 
to the subject of scarlatina by the prevalence of a 
severe epidemic of it in Saxony; and which invaded 
his own family soon after he had begun his inves- 



ATROPA BELLADONNA. 



271 



tigations of the law of cure and his provings of 
drugs upon the healthy subject. Having become 
satisfied of the close resemblance existing between 
the character of the prevailing epidemic and the 
effects of Belladonna, he went further, and conject- 
ured that Belladonna might prove a prophylactic 
against the disease. The story of this discovery 
may best be told in his own words: 

"The mother of a large family, at the com- 
mencement of July, 1799, when the scarlet fever 
was most prevalent and fatal, had got a new coun- 
terpane made up by a sempstress, who (without 
the knowledge of the former) had in her small 
chamber a boy just recovering from scarlet fever. 
The first-mentioned woman, on receiving it, exam- 
ined and smelt it, but as she could detect no smell, 
she placed it beside her on a sofa on which, some 
hours later, she lay down to sleep. In this way 
alone she imbibed the miasm. A week subse- 
quently she was suddenly attacked with quinsy 
and its characteristic shooting pains in the throat, 
which were subdued in four days. Several days 
afterward, her daughter, ten years of age, was 
attacked in the evening by severe pressive pains 
in the abdomen, itching of the head and body, 
rigor over the head and arms and paralytic stiff- 
ness of the joints. Her sleep was restless during 
the night, with frightful dreams and general perspi- 
ration, excepting the head. 

"I found her in the morning with pressive head- 
ache, dimness of vision, slimy tongue, some 



272 



ATROPA BELLADONNA. 



ptyalism, the sub-maxillary glands hard, swollen and 
painful to the touch, and shooting pains in the 
throat when attempting to swallow. She was free 
from thirst; pulse quick and small; breathing hur- 
ried and anxious; very pale though feeling hot; 
horripilation; leaning forward to lessen the pain; 
she complained of stiffness with an air of much 
dejection, and shunned conversation, feeling that she 
could only speak in a whisper. Her look was 
dull, yet staring; her eyelids widely stretched, face 
pale and features sunk. 

"Knowing too well the ineffectual nature of the 
ordinary favorite remedies, I resolved, in this case 
of incipient scarlet fever, not to act with reference 
to individual symptoms, but (agreeably to my new 
synthetical principle) to obtain, if possible, a rem- 
edy calculated to produce in a healthy person most 
of the morbid symptoms I now observed ; and my 
memory and written remarks suggested no remedy 
so appropriate as Belladonna, which I had observed 
to produce precisely the above-mentioned symp- 
toms. 

"I therefore gave the girl, who was already 
affected by the first indications of scarlet fever, a 
dose of Belladonna (432,000 of a grain of the 
extract, which, according to my subsequent expe- 
rience, is too large a dose). She remained quietly 
seated all day, without lying down; the heat of 
her body diminished, she drank but little; none of 
her symptoms increased, and no new ones appeared. 
She slept quietly, and the following morning, 



ATROPA BELLADONNA. 273 

twenty hours after taking the medicine, most of the 
symptoms had disappeared without any crisis; the 
sore throat only continued, but in a less degree, 
till the evening, when it went off. The following 
day she was lively, and ate and played as usual. 

"I gave her a second dose, and she remained 
perfectly well, while two other children of the 
family fell ill of the scarlet fever without my knowl- 
edge, whom I could only treat according to my 
general plan detailed above. I gave my convales- 
cent a smaller dose of Belladonna every three or 
four days, and she continued in perfect health. 

"I now earnestly desired to preserve the other 
five children from infection; their removal being 
impossible, and I thus reasoned: a remedy capable 
of quickly checking a disease in its first onset must 
be its best preventive, and the following occurrence 
strengthened my opinion: Some weeks previously 
three children of another family were ill of severe 
scarlet fever. The eldest daughter alone, who had 
been taking Belladonna internally for an external 
affection of the joints of her fingers, to my great 
astonishment escaped the infection, although in 
other cases of epidemics she had readily taken 
them. 

"This decided me to administer to the other five 
children very small doses of this excellent remedy 
as a preservative, and as its action lasts only three 
days, I repeated the dose every seventy-two hours, 
and they all remained in perfect health, though 
surrounded with infection. 
19 



ATROPA BELLADONNA. 



"In the meantime, I was called to attend another 
family where the eldest son was ill of scarlet fever. 
I found him in the height of the fever, with the 
eruption on the chest and arms. He was seriously 
ill, and it was too late to give the specific prophy- 
lactic remedy. But, wishing to preserve the other 
children of four and two years old and nine 
months, I directed the parents to give the requisite 
dose of Belladonna every three days, and had the 
happiness of seeing them escape the disease in 
spite of constant intercourse with their sick brother." 

By this narrative Hahnemann introduced to the 
medical world what he thought a discovery of great 
value. Scarlatina prevailed extensively in Europe 
at that time and during the first quarter of the 
present century. Belladonna as a prophylactic was 
tried in thousands of cases and by hundreds of 
physicians. The testimony in its favor was not 
unanimous, but greatly preponderating. 

Hufeland, the great protomedicus of Prussia, 
reported in favor of its prophylactic action. His 
report was based on observations of his own and 
the sum of the testimony of others. In consequence 
of his report the Prussian government, in 1838, 
decreed that it should be obligatory on physicians 
to give Belladonna as a prophylactic whenever 
scarlatina prevailed as an epidemic. 

Pareira endeavors to throw doubt on the argu- 
ments and evidence in its favor, but Dr. Stille, of 
Philadelphia, the most recent writer, speaks as fol- 
lows (ii. 51) : 



ATROPA BELLADONNA. 



275 



" On a review of the whole subject we feel bound 
to express the conviction that the virtues of Bella- 
donna as a protective against scarlatina are so far 
proven that it becomes the duty of practitioners to 
invoke their aid whenever the disease breaks out 
in a locality where there are persons liable to the 
contagion." 

The evidence of the prophylactic power of 
Belladonna will appear stronger if we consider two 
facts : 

1. As Stille remarks, the paucity of the cases 
of some objectors, and the meagerness of the de- 
tails furnished by others, deprive their evidence of 
real weight : and 

2. It is notorious that epidemics often differ very 
widely from each other in characteristic symptoms, 
even though the same name 'may be applied to 
them. Now, if Hahnemann's reason for giving Bel- 
ladonna as a prophylactic be correct, Belladonna 
would only be a prophylactic against an epidemic 
miasm, the disease resulting from which closely 
resembled the symptoms produced on the healthy 
by Belladonna. In an epidemic which did not re- 
semble the effects of Belladonna, that remedy would 
not be a sure prophylactic. 

Hahnemann himself pointed out this fact in 
his preface to Belladonna. He says : 

"The property I have discovered in Belladonna, 
given in a small dose every six or seven days, of 
being a preservative against scarlatina, as Syden- 
ham, Plenciz and others have described it, was for 



276 



ATROPA BELLADONNA. 



nineteen years brought into contempt by physicians, 
who, ignorant that the disease belongs only to chil- 
dren, have confounded it with the purple miliary 
rash introduced from Belgium in 1801, and have 
applied to the latter my method, which of course 
failed. I rejoice, however, that of late years other 
physicians have distinguished the ancient and true 
scarlatina, establishing the preservative property of 
Belladonna in that disease, and have thus rendered 
justice to my labors, so long misunderstood." 

Remedies. Little need be added to what has 
already been said on the subject of Belladonna as a 
remedy for scarlatina. Its correspondence to the 
majority of cases in epidemics presenting no peculiar 
type is very manifest. But epidemics do occur; 
and we have had several of late years in which the 
symptoms do not correspond so closely to the 
symptoms of Belladonna as of some other drug ; as, 
for example, of Stramonium. 

It behooves us, therefore, to avoid here as ever 
the great error of prescribing according to the name 
which we may have given to the disease; and to 
study closely the symptoms of each case, and com- 
pare with those of various drugs of the Materia 
Medica, so as to select that which shall best corre- 
spond. 

If, now, we have thus chosen Belladonna, this 
remedy may be sufficient to carry the case through 
to convalescence. Frequently, however, this will 
not be so. Tendencies to chronic disease hitherto 
latent may be aroused in the patient by the scarla- 



ATROPA BELLADONNA. 



2/7 



tina poison, and may become active. Then we 
shall require to enter upon a course of treatment 
of a chronic disease ; and it is not probable that 
Belladonna will be of further service. 

This awakening of chronic tendencies often takes 
place about the third day of the rash. It is of 
great importance to take it in the beginning. Hence 
the rule which has been suggested, that on the day 
above mentioned the careful physician shall care- 
fully examine the patient, with a view of detecting 
tendencies to chronic disease, and should be prompt 
to prescribe accordingly. Rhus, Calcarea carbonica, 
Hepar sulphuris, are remedies likely to be required. 

Epilepsy. In this disease Belladonna has been 
more successful than perhaps any other one remedy. 
Some brilliant cures of this terrible disease are on 
record. In all cases which it has favorably affected, 
the spasms were accompanied by the general symp- 
toms above recited as characteristic of Belladonna. 

The same remarks may be made of puerperal 
convulsions. 

Erysipelas. No mention has yet been made of 
the use of Belladonna in erysipelas. And yet in 
the smooth, shining affection, especially of the face 
and head, it has been of greatest value. Mr. 
Liston, of London, though not a homceopathist, 
bore testimony to its efficacy in the hands of 
homceopathists. Its homceopathicity cannot be 
questioned. 



HYOSCYAMUS NIGER. 



HENBANE. 

IS classed along with Belladonna among the nar- 
cotics, or among the cerebro-stimulants. It 
resembles Belladonna in some respects, though 
lacking its power to act on a number of organs 
and systems of the body, and acting very differ- 
ently on others. 

It has been used as a medicine from the earliest 
ages; but was brought into prominent notice by 
Stoerck. 

Swine eat it with impunity. It is peculiarly 
fatal to fowls. Hence its name. 
It acts on dogs as on men. 

On men it produces, in large doses, delirium 
resembling that of drunkenness, — a garrulous delir- 
ium, with proneness to altercation and quarrelsome- 
ness. Hence one of its ancient names, Altercum. 
Its power to produce an excited or quarrelsome or 
fantastic mania is universally conceded. The effects 
are, moreover, "fullness and heat of the head, 
flushing of the face, injection of the eyes and 



HYOSCYAMUS NIGER. 



cerebral excitement, manifested by indistinct or 
clouded vision, and sometimes total blindness, gid- 
diness, delirium and hallucinations. Sometimes 
natural objects assume a grotesque appearance, or 
the field of vision is filled by luminous figures. 

" There is little or no inclination to sound 
sleep, but a sort of somnolence with incoherent 
mutterings, like that which is so common in 
typhoid fever. 

" Sometimes the hearing is lost. The pupils are 
often, but not always, dilated; the muscles of the 
throat and chest, and of the lower limbs, are 
affected with tetanic rigidity or clonic spasms; and 
there is more or less complete loss of power in the 
same parts, which is apt to continue after the 
attack. Aphonia is by no means uncommon. 
General sensibility is in most cases very much 
impaired, while at the same time there may be 
severe neuralgic pains in the course of the princi- 
pal nervous trunks. The skin is apt to be bathed 
in perspiration, which is sometimes cold when a 
large dose has been taken. Sometimes the tongue 
is paralyzed and the pharynx spasmodically con- 
tracted." (Stille, vol. ii., 24.) 

The summary taken from Orfila and Stille 
shows the homoeopathic relation of Hyoscyamus to 
many cases in which homceopathists have success- 
fully used it, as we shall see. 

Our knowledge of its physical action is derived 
from Hahnemann's proving. (R. A. M. L., iv.) 

The whole plant is used in medicine. 



28o 



HVOSCYAMUS NIGER. 



The action of Hyoscyamus on the vital power 
is marked. 

1. On the sensorium it produces perversion of 
perception, so that illusions perplex the patient; he 
sees things which have no existence ; also perver- 
sion of intellectual action; he reasons erroneously, 
A distinct mania of the quarrelsome or obscene 
character. The patient would escape, or would be 
undressed and walk about nude, or use offensive 
and. unbecoming language and gestures, or quarrel 
with by-standers. 

2. On the muscular system. It paralyzes and 
convulses the voluntary muscular system, e. g. t the 
extremities, and paralyzes the involuntary system, 
produces convulsions and paralysis (with pal z face, 
quiet pulse, nervousness). As, for example, paralysis 
of the constrictors of the pharynx, and also of the 
sphincter ani. 

The action on the organic substances of the 
body is so slight that we can hardly define it. • 

The sphere of action of the drug seems to be 
confined : 

1. To the sensorium, producing the peculiar 
forms of mania and delirium alluded to. 

2. To the muscular system, producing partial 
or general convulsions, and also paralysis of the, 
sphincters. 

3. To the nervous supply of the larynx and 
trachea, producing a tickling cough. 

4. To the sleep: Produces at first, under small 
doses, an unwonted liveliness and difficulty in get- 



HYOSCYAMUS NIGER. 



28l 



ting asleep; sleeplessness and frequent waking, with 
exaltation of mind and vivid imaginings. Even 
when it occurs the sleep is very unquiet, the limbs 
twitch or are contorted into various grotesque 
shapes, the hands clutch at the bedclothes or 
grope about here and there; there are convulsive 
twitches, startings up in affright, grinding of the 
teeth, groaning and starting in sleep. 

The peculiarities of Hyoscyamus may be noted 
as follows: First the convulsions, the mania, the 
delirium, the cough, the sleeplessness, all occur 
almost absolutely without any manifestations of 
fever. In this respect it presents a marked contrast 
to Belladonna. 

2. The singular and definite character of the 
mania, which is loquacious and quarrelsome, the 
subject of it being especially inclined to unseemly 
and immodest acts, gestures or expressions. 

It differs from that of Stramonium in these par- 
ticulars: The latter produces mania with some 
degree of fever (though less than Belladonna), and 
in it the patients, though loquacious, are good- 
natured and fully occupied with the observation of 
the phantoms by which they fancy themselves to 
be surrounded. 

The spasmodic affections may be either subsul- 
tus tendinum of a single extremity or general 
epileptic convulsions; the limbs are forcibly curved 
and the body is thrown up from the bed ; the 
patient then falls with a cry and is generally con- 
vulsed. It resembles and is useful in convulsions 



282 



HYOSCYAMUS NIGER. 



from intestinal worms, and especially in puerperal 
convulsions ; also spasm of pharynx and cesophagus. 

The cough of Hyoscyamus is a dry, nervous, 
spasmodic cough, which occurs at night, and ceases 
when the patient sits up; this is a certain charac- 
teristic of Hyoscyamus. The Belladonna cough 
often compels the patient to sit up, but does 
not thereupon cease. 

The symptoms generally are aggravated at 
night. 

The forces sink quickly; the patient gets easily 
fatigued ; syncope is readily produced ; the limbs 
become cold and tremble. These symptoms, with 
those of the sleep, the paralysis of the sphincters, 
point to the use of Hyoscyamus in some conditions 
occurring in the course of continued fevers. 

SPECIAL ANALYSIS. 

The vertigo of Hyoscyamus is attended by 
obscuration of vision, and loss of the general sen- 
sibility of the external surface of the body. 

The head becomes heavy and confused. The 
pains which, however, are ill -defined; are mostly in 
the forehead. When walking there is a sensation 
as of a wave within the cranium with pressing in 
the forehead. 

Heat in the head and in the forehead. 

The eye presents no evidence of organic affec- 
tion, whether subjective or objective. On the other 
hand, vision is eminently affected. 

The sight is obscured; illusions are very various; 



HYOSCYAMUS NIGER. 



283 



fiery red objects appear. When reading, the letters 
move about, small objects appear large ; in sewing, 
the needle goes to the wrong place. 

The eyes become short-sighted ; they are dis- 
torted ; they stare and protrude. 

Hyoscyamus has proved an excellent remedy 
for squinting and for double vision. 

The face is distorted; the risus sardonicus is 
produced. 

There is roaring in the ears. 

In the throat, dryness and inability to swallow, 
but not from swelling or soreness. The affection 
is purely nervous or spasmodic. 

The digestive organs present nothing character- 
istic. 

The stool is inclined to be loose and diarrhceic. 
It is characteristic that it passes involuntarily. 

The secretion of urine is perhaps diminished. 
The bladder itself is often paralyzed, so that urine 
accumulates and the patient is unable to expel it 
or unconscious of its presence. 

A number of these symptoms suggest Hyoscy- 
amus as likely to be useful in the puerperal state. 

The menses are too copious, and are preceded 
by labor-like pains. 

The symptoms of the extremities have been 
noted. 

The disposition is exceedingly despondent and 
melancholy (save in the mania). A peculiar feat- 
ure is the production of a state of mind resem- 
bling jealousy. Hence Hyoscyamus acquired some 



284 



HYOSCYAMUS NIGER. 



reputation in illness arising from disappointments 
in love, etc. The physiology of this is a matter 
of speculation. 

PRACTICAL APPLICATIONS. 

A few only of the applications of Hyoscyamus 
which, according to the law Si'milia similibus 
curantur, would suggest themselves in accordance 
with the above symptoms, need be specified par- 
ticularly. 

In spasms of various kinds, involving the volun- 
tary muscular system, Hyoscyamus has proved a 
most valuable remedy. 

If general, the convulsion differs from that for 
which Belladonna is indicated in this particular, 
that it is neither preceded, accompanied nor fol- 
lowed by symptoms of cerebral congestion or of 
great arterial energy of action, as is the case 
with Belladonna convulsions. Indeed, the absence 
of all such signs is remarkable under Hyoscyamus. 
Now, of all convulsive affections that could exist 
without these symptoms, none are so probable as 
convulsions from the irritation of intestinal worms, 
and more particularly the convulsions that some- 
times unhappily attend and complicate labor and 
the puerperal state. Of course some puerperal 
convulsions are accompanied by the cerebral con- 
gestion and arterial storm, and these may require 
Belladonna. But there is a large class which have 
them not, and of these Hyoscyamus is a con- 
spicuous remedy. 



HYOSCYAMUS NIGER. 



Similar remarks might be made respecting the 
mania which is curable by Hyoscyamus. The 
especial adaptation of it to certain non-congestive 
or non-inflammatory forms of puerperal mania 
has been fully recognized and established in clini- 
cal experience. 

The character of the mental affection is one 
which is prevalent in puerperal mania, or in 
mania relating to, or in any way depending on, 
functional or organic maladies of the sexual organs 
of women. 

The tendency to loquacity, to quarreling, to the 
use of indelicate language and of immodest gest- 
ures and actions, all remind one forcibly of the 
graphic instances of this distressing affection 
described by Gooch, and which we sometimes see. 

An example of this kind of mania, occurring, 
however, in an unmarried young woman, in 
sequence of some menstrual irregularity, and cured 
by Dr. Guernsey, of Philadelphia, is a remarkable 
instance of — 

1. The efficacy of Hyoscyamus in mania. 

2. The efficacy of a single small dose of a 
remedy, if well selected, in the cure of a terrible 
malady. 

3. The value of the homoeopathic law as guid- 
ing us in selecting the right drug. 

A young woman, apparently well, except that 
she had recently had irregular menstruation, one 
morning refused to rise from bed and dress herself. 
She assigned no reason. After a few hours she 



286 



HYOSCYAMUS NIGER. 



insisted on rising, but would not wear a single 
garment of any kind. 

Her parents, alarmed, sought advice. .• Dr. 
Guernsey called. The patient received him without 
any apparent consciousness of her singular condi- 
tion, conversed intelligently, but would not admit 
that she needed any advice to clothe herself. She 
refused medicine, and cunningly evaded all strata- 
gems to give it clandestinely. 

Several days passed in this way. She escaped 
from her room, went through the house, and 
sought to escape into the street. At length, when 
matters were growing worse, Dr. Guernsey suc- 
ceeded in getting her to take a dose of Hyoscya- 
mus 2 °°. In a few hours she was well, dressed, 
and behaved as when in good health. 

The symptoms which controlled Dr. Guernsey's 
choice of Hyoscyamus are the following: 

(445.) He makes himself naked. 

He lies in bed nude and chatters. He walks 
about insane, naked, wrapped in a skin during the 
summer heat, etc., and others to the same purport. 

In convulsive affections of the pharynx, which 
interfere with or prevent deglutition, the symptoms 
would lead us to infer the usefulness of Hyoscya- 
mus ; and Hahnemann speaks confidently of its 
power to cure hydrophobia, the symptoms other- 
wise corresponding. 

In affections of the eye, involving the special 
sense alone, Hyoscyamus may be a valuable rem- 
edy, as the symptoms show. 



HYOSCYAMUS NIGER. 287 

As regards the digestive apparatus, it will have 
been observed that Hyoscyamus produces a kind 
of diarrhcea. This is characterized by involuntary 
evacuations during the sleep at night, apparently 
from inertia of the sphincter ani. This must not 
be confounded with the involuntary defecation 
which attends the blood dyscrasia in typhus, etc. 
It is a paralysis of the sphincter. 

Dr. Wurmb says : " Hyoscyamus is indicated in 
those fever cases in which torpor of the entire 
organism predominates. The patients have a dull, 
fixed expression of face, delirium is lacking, or if 
present, it consists of a confused farrago of com- 
plex images ; the perceptive faculty is almost sus- 
pended." 

The cough of Hyoscyamus has been described. 
It is a very useful remedy. 

For sleeplessness or dozing with the brain full 
of figures and bewildering images, Hyoscyamus is 
a very valuable remedy if other symptoms corre- 
spond. 



DATURA STRAMONIUM. 



THORN APPLE OR JAMESTOWN WEED. 

INDIGENOUS in the United States and Europe. 
So common in our waste places about the cities 
that cases of poisoning with it are by no means 
uncommon. 

Goats eat the leaves with impunity. Cows, if 
affected by it, are not easily affected. But after eat- 
ing it, their milk has proved poisonous to children. 

This drug, the action of which resembles very 
closely in many particulars that of Belladonna, was 
brought into prominent notice as a remedy by 
Stoerck, of Vienna, who advised its internal use in 
mania and epilepsy. 

"If," says he, "Stramonium produces symptoms 
of madness in a healthy person, would it not be 
desirable to make experiments in order to discover 
whether this plant, by its effects on the brain, in 
changing the ideas and the state of the sensorium 
(i. e., of the part, whatever it be, which is the 
center of action of the nerves upon the body), 
should we not, I say, try whether this plant would 



DATURA STRAMONIUM. 



289 



not restore to a healthy state those who are suffer- 
ing from alienation of mind ; and if, by the change 
which Stramonium would cause in those who suffer 
from convulsions, by putting them in a contrary 
state to that in which they were, would it not 
cause their cure?" This was written in 1762. 

By allopathic physicians it has been successfully 
employed against epilepsy in Stockholm, and by 
both allopathic and homoeopathic physicians against 
mania. 

The following general summary of its effects is 
taken chiefly from Trousseau and Pidoux : 

"In moderate doses, Stramonium produces slight 
vertigo and a disposition to sleep ; the muscular 
energy is lessened ; the sensibility is blunted ; dila- 
tation of the pupil ; slight obscuration of vision ; 
acceleration of pulse ; elevation of the heat of the 
skin ; thirst ; a slight burning in the fauces. Gen- 
erally the bowels are relaxed ; the urine is more 
abundant than common ; there is copious per- 
spiration, provided there be neither diuresis nor 
diarrhoea. 

"But, in larger doses, vertigo, general debility; 
some degree of stupor ; soon the vision becomes 
obscured ; there is enormous dilatation of the pupils, 
agitation, spasms, furious delirium, continual hallu- 
cinations, obstinate insomnia, high fever; the skin 
is hot, dry and often covered with an eruption 
closely resembling that of scarlatina, burning thirst, 
and very painful dryness and constriction of the 
pharynx; often impossible to swallow; cardialgia; 
20 



29O DATURA STRAMONIUM. 

vomitings ; sometimes diarrhoea ; frequent desire to 
pass water, with but little or no urine. 

" When the poisoning is to prove fatal, the 
extreme agitation is succeeded by collapse, coldness 
and death. In the more happy and more frequent 
cases, the hallucinations cease little by little, 
delirium comes to an end, and of this whole col- 
lection of formidable symptoms there remain only 
the dilatation of the pupils, the obscuration of vision, 
and sometimes a transient blindness. The delirium 
and the blindness, however, have been known to 
persist for several days, and even for weeks. 

"The delirium is sometimes gay, sometimes 
sad, but is always accompanied by singular hallu- 
cinations and fantastic visions." 

Our more exact knowledge of the effects of 
Stramonium is derived from Hahnemann's proving 
of it. ("Materia Medica Pura," vol. iii.) 

Upon the vital force Stramonium exerts a very 
powerful and characteristic action. 

1. The sensorium is both exalted in activity, 
as the vigilance shows; and perverted in its func- 
tions, as we gather from the mania, the hallucina- 
tion and the fantastic visions which universally 
result from it. 

The special sense of vision is perverted, as wit- 
ness the double vision and the peculiar false vision, 
as well as the colors seen by the patient; and it is 
blunted, blindness resulting. 

The general sensibility is blunted; the function 
of voluntary motion is affected; convulsive motions 



DATURA STRAMONIUM. 29 1 

of the extremities ensue, particularly of the arms 
and of the face. Isolated groups of muscles are 
convulsed. 

The function of the secreting surfaces of various 
organs is suspended. The secretion of urine is 
suspended, and so is that from the surface of the 
intestine, by large doses. 

2. On the other hand, the organic substance 
is hardly affected, save in the eruption which covers 
the skin, and in the greenish diarrhoea which some- 
times follows a small dose. 

3. There is no marked periodicity of action. 

4. The peculiarities of the action of Stramo- 
nium are the following: The mania and delirium 
are not attended or followed by high fever; the 
hallucinations are real as in the second stage of 
delirium tremens; the convulsions affect the arms 
more than the lower extremities; and consist in a 
trembling and convulsive groping forward with the 
hands; finally, the peculiar false and double vision 
in which the patient, looking at an object, sees it 
repeated a little above and at the left side of the 
original, or in which only a small part of an object 
is to be seen at once, as for example the nose on 
a person's face, etc. 

The suppression of urine is a noteworthy symp- 
tom. 

The convulsions are often provoked by looking 
at a light, or upon a reflecting surface as a mirror 
or water, and also by contact. 

The limbs feel as if separated joint from joint. 



292 DATURA STRAMONIUM, 

The vertigo of Stramonium resembles that of 
Belladonna, and makes the gait unsteady. 

No special headache is ascribed to it. Consid- 
erable congestion of blood to the head is produced, 
with heat and spasmodic drawing of the head hither 
and thither. 

The face is generally swollen, has at first a 
pleasant expression, except for the fixed stare of 
the eyes; subsequently the face becomes distorted. 

Vision is much affected, colors are not correctly 
distinguished. Black objects generally appear gray, 
everything seems to be tipping over; the letters 
on a printed page seem to move, or they and other 
objects appear double. There seems to be a fog 
before the eyes, or it seems as if one looked 
through a glass of turbid water. Sometimes abso- 
lute blindness ensues. The pupils are enormously 
dilated. The eyes are sometimes red, and there 
is involuntary discharge of tears. No organic 
lesions. 

The mouth and throat are very dry, although 
the tongue is moist. Violent thirst but inability 
to swallow, because the throat seems to be con- 
stricted. The vocal organs seem to be paralyzed, 
the tongue trembles, the patient stammers and 
murmurs unintelligibly; or is absolutely dumb, 
and indicates with signs the objects of his desire; 
or, if he speaks, his voice is shrill, fine and high- 
pitched, but he has to make great effort to get 
out a word. 

Notice that this is without fever, without swell- 



DATURA STRAMONIUM. 



293 



ing or any pain within or without the throat. 
There is here, then, no laryngitis, but simply a 
convulsion of the laryngeal muscles and vocal 
chords. 

The taste is bitter; vomiting of green bile 
occurs on motion, or even on sitting up in bed. 

Great anxiety in the epigastric region. The 
abdomen is distended, with rumbling and gurgling 
in it, and painful to pressure. 

As a rule, the evacuations are suppressed, but 
we rind urgency to stool yet no stool. Urine is 
suppressed; yet there is urgency to pass water. 

The menses are increased. The flow occurs in 
large coagula, with drawing pain in the abdomen, 
in the ilium and other parts. 

With regard to the respiratory organs, we find 
no cough as by Hyoscyamus and Belladonna, but 
respiration is difficult and constricted, generally 
with anxious respiration and lividity of the face. A 
pressing pain in the chest, which is provoked by 
talking, with difficult respiration; it is hardly possi- 
ble to draw in the breath. These symptoms are 
of great interest in connection with the empirical 
use of Stramonium in asthma. 

In the trunk and extremities hardly any symp- 
toms are observed, save the convulsive movements, 
sense of lassitude in the back and drawing pains 
in the spine, the sacrum and the ilium. 

The sleep is either solid and sound and deep, 
with loud snoring, the patient lying on the back, 
with the eyes fixed and open; or else it is light, 



294 



DATURA STRAMONIUM. 



with troublesome dreams and disturbed by startings, 
cryings and wakings. 

The fever is moderate. The chill, if it occur, 
is general, with twitching of single groups of 
muscles. Heat is chiefly in the face, or, if it 
be general, it is characteristic that, during it, the 
patient carefully covers himself up. (Ignatia.) 
Sweat copious. 

The disposition resembles a genuine mania, 
distinguished by loquacity, hallucinations and ridic- 
ulous attitudes and gestures; the hallucinations 
completely possess the patient. 

But sometimes this mania amounts to absolute 
rage, with disposition to strike and bite, and alter- 
nating with convulsions. 

PRACTICAL APPLICATIONS. 

Remarks on practical applications of Stramonium 
may best be prefaced by the following remarks 
from Hahnemann's introduction: 

" During its primary action, Stramonium pro- 
duces no pain, properly so called, though it does 
cause very unpleasant sensations. 

"The primary effect is to increase the activity 
of the voluntary muscles, and to suppress all the 
secretions, a state exactly contrary to the secon- 
dary effect which paralyzes the muscles and in 
which the excretions are superabundant. For the 
same reason, when taken in a proper dose, it 
soothes spasmodic muscular action, and restores the 
course of the suppressed excretions in many cases 



DATURA STRAMONIUM. 



295 



where absence of pain predominates; this plant, 
therefore, can only cure homceopathically when the 
morbid state corresponds with its own primary 
effect 

"But, and here I speak from experience, what 
incomparable curative power has not the homoeopa- 
thic application of the mental derangement excited 
specially by Stramonium exerted in analogous 
mental diseases arising from other causes; and how 
salutary is this plant in convulsive affections similar 
to those which it provokes. I have found great 
benefit from it in certain epidemic fevers having 
symptoms analogous mentally and physically to its 
own. 

"But, as mania shows various modifications, so 
we cannot always obtain a cure for it by one 
remedy. In certain cases we must have recourse 
to Belladonna, in others to Henbane, in others 
to Stramonium, according as the symptoms corre- 
spond homceopathically with one or the other of 
these three drugs. 

" Moderate doses only keep up their action 
thirty-six to forty-eight hours; weaker doses a still 
shorter time." 

In mania, Stramonium is a most valuable rem- 
edy. The form which requires it has less fever 
than that of Belladonna; more convulsion, and 
especially convulsion of isolated groups of mus- 
cles; more hallucination. It has more fever than 
that of Hyoscyamus, less loquacity, no quarrel- 
someness, but, on the contrary, good nature; the 



296 



DATURA STRAMONIUM. 



hallucinations are real, not, as under Hyoscyamus, 
half real, bewildering the patient. 

Convulsions. Stramonium has been found useful 
in epilepsy as well as in other forms of spas- 
modic disease. It is remarkable, however, that 
the convulsions produced by it are partial, rather 
than general, affecting the arms rather than the 
lower extremities; affecting, also, isolated groups 
of muscles. Thus, we have twitchings of the 
extremities and of the facial muscles, jerkings of 
the head, etc. 

From these symptoms we should be inclined 
to draw an indication for the use of Stramonium 
in chorea; and it has been found the most 
useful drug in the materia medica in this malady. 

It should be noted, however, that chorea 
being almost always (at least in my experience) 
associated with, if not based upon, a depraved 
and vitiated state of the nutrition involving 
changes of organic substance, no such remedy 
as Stramonium, which does not modify nutrition 
nor alter the organic substance, can be relied 
upon as the sole or even the chief remedy; I 
have, accordingly, though finding Stramonium 
very useful to moderate the severity of the 
purely nervous phenomena, been obliged to trust 
to such remedies, alterative in their character, 
as Calcarea carbonica, Natrum muriaticum and 
Sepia, or Sulphur, for a permanent cure. 

In delirium tremens, it is easy to see that Stra- 
monium would be clearly indicated in the second 



DATURA STRAMONIUM. 



297 



stage too. It has been tried and with admirable 
success. 

The spasmodic affection of the pharynx, and 
the fact that the various convulsive affections are 
brought on by the sight of water, etc., suggest 
the use of Stramonium in hydrophobia. Hahne- 
mann affirms that it has been successfully used in 
some forms of the disease. 

Stramonium has been of greatest service in 
suppression of the urine, without pain or discom- 
fort, such suppression usually occurring in the 
course of long fevers, e. g., typhoid or typhus, 
not a simple retention of urine in the bladder ; in 
such a case Opium would do better. 

Likewise in suppression of urine after miscar- 
riage or after labor, where the desire to pass water 
is great but there is no ability to accomplish it, 
Stramonium will give speedy relief, provided always 
the case be not one of retention from a mechanical 
cause, such as retroversion of the uterus. 

In affections of the respiratory organs, Stra- 
monium has acquired a great reputation for the 
relief of asthma. It was used as follows: The 
dried leaves were smoked in a pipe, sometimes 
alone and sometimes with niter ; giving often relief 
but sometimes causing damage. 

In scarlatina, Stramonium stands next to Bella- 
donna. The eruption is generally reported as 
being very like scarlatina. The fever is less than 
that of Belladonna. The throat affection is less 
than that of Belladonna. At the same time, from 



298 DATURA STRAMONIUM. 

the suppression of urine, we may infer that Stra- 
monium affects the kidneys more than Belladonna.. 
It is thought that Stramonium suits now a larger 
class than heretofore. (See the article of Dr. 
Wells on scarlet fever, " American Homoeopathic 
Review," vcls. iv., v. and vi.) 

The following case of poisoning from the appli- 
cation of Stramonium . leaves to an ulcer came 
under my own observation : 

A mechanic, about forty-four years old, whose 
health had suffered greatly in consequence of a 
severe bilious remittent fever and the heroic doses 
of calomel prescribed for its cure, had been under 
my care several weeks for large irritable ulcers 
upon both legs. I was called in haste, early one 
morning, and was informed that my patient was 
" not right in his mind." 

I found him dressed and lying on a lounge. 
He recognized me and immediately apologized for 
not rising, stating that his limbs were not under 
his control ; and, in fact, I found afterward that 
they were paralyzed. His face was covered with 
patches of an irregular shape, not elevated above 
the rest of the skin and of a brilliant fiery red 
color. The conjunctiva was injected, the pupils 
immensely dilated ; the whole expression of the eye 
was brilliant, restless, suspicious and roving. The 
brow was corrugated. The appearance of the 
patient suggested mania and I might have at once 
pronounced it a case of delirium tremens, had I 
not well known the temperate habits of my patient. 



•DATURA STRAMONIUM. 



299 



The tongue was moist, the papillae enlarged and 
projecting through a soft white fur. The limbs 
were motionless. The arms on the contrary were 
constantly reaching forward and upward with an 
uncertain tremulous motion, as if the patient were 
endeavoring to seize some object which he indis- 
tinctly perceived in the air. As I sat observing 
him, he suddenly turned toward the wall, exclaim- 
ing, "There are those bugs! help me to catch them !" 
"What bugs?" I asked. "There," he replied, "a 
long train of bed-bugs, and after them a proces- 
sion of beetles, and here comes crawling over me 
a host of cockroaches." He shrank back in much 
alarm. Then suddenly he turned to me, saying, 
" I believe I know they are not really bugs ; but, 
except once in a while, they seem real to me !" 
This scene was many times repeated. For some 
time I was at a loss to account for the condition 
of my patient. At length the peculiar, almost 
convulsive, motions of his upper extremities while 
the lower extremities were nearly paralyzed, together 
with the aspect of the face and the mental condition 
suggested Stramonium to my mind. His family 
knew nothing of his having used it, but when he 
heard me mention the name, he pointed to his legs, 
where, on examination, I found a quantity of the 
bruised green leaves which he had applied to the 
ulcers, it seems, the night before, in the hope of 
relieving pain. 

The poisoning not being very serious, I con- 
tented myself with removing the leaves and allow- 



300 



DATURA STRAMONIUM. 



ing the effects of the poison to pass away without 
administering any antidote. 

The mental symptoms produced in this case 
by the Stramonium so closely resembled those of 
the second stage of delirium tremens, as to point 
strongly to Stramonium as a valuable remedy in 
that disease. 1 



1 See a case of poisoning by 
Stramonium, recorded by Dr. 
Meigs, in the " North American 
Medical and Surgical Journal," 
January, 1827. Also, " Frank's 
Magazine," vol. ii., p. 230. Case 



of poisoning from eating Stramo- 
nium seeds. Also, poisoning by 
Stramonium seeds, narrated by 
Dr. Johnson, " American Medi- 
cal Times," i., 22, i860. 



OPIUM. 



INSPISSATED juice of the Papaver somniferum. 
We derive it from Turkey and from India; it is 
also made in France. It has been used from early 
ages. In most countries now, it affords a disrep- 
utable but very common means of indulging in 
intoxication. 

No drug is so universally used in the old 
school of medicine. The great Hufeland affirmed 
that if he had to choose one remedy from the 
materia medica for exclusive use it should be 
Opium. Its extensive use among allopathists fol- 
lows from these facts. The old school has few 
specifics, and these are but seldom used. Most 
diseases being attended with pain, the pain must 
be either subdued by acting specifically upon the 
causes of pain, or else the pain must be relieved 
by a palliative anodyne, while the disease is sought 
to be cured by the use of revulsive agents addressed 
to other organs of the body than those which are 
the seat of disease. The latter is the mode almost 
universally employed. Hence the constant use of 
anodynes. For example, in severe sclerotitis, the 



302 



OPIUM. 



old school would use revulsive agents addressed to 
the bowels (purges) and to the skin (blisters) ; 
but, at the same time, to subdue the pain in the 
eye, a dose of Opium would be given. 

Homoeopathy does not do so. It gives a drug 
that acts specifically on the cause of disease and 
upon the organ diseased and no other, and there 
is no need of an anodyne. These are the rea- 
sons why Opium is so much used by allopaths and 
so little by homceopathicians. 

Hahnemann's observations, though requiring 
some modifications perhaps in consequence of the 
wider experience of later years, are most instruct- 
ive. "The primary result of weak and moderate 
doses, during whose action the organism is affected 
in a passive manner, appears to be to excite 
for a short time the irritability and activity of 
the muscles subject to its action, but also to dimin- 
ish for a longer time that of the muscles which 
are not subjected to its influence ; to excite the 
imagination and the courage, but also to deaden 
and stupefy the feelings, the sensibility and presence 
of mind. Under a longer continuance of its action, 
the organism, by its power of reaction, produces a 
condition exactly the reverse, — a want of excitability 
and activity in the involuntary muscles, an absence 
of ideas, languor of imagination with timidity and 
over-sensibility of the general feeling. Certain 
symptoms are more palpable in some individuals 
than in others. No medicine relieves suffering- 
sooner than Opium. It is this property that has 



OPIUM. 303 

induced physicians to employ it so largely — a 
source of innumerable evils. If the use of Opium 
in disease were as beneficial as it is frequent, no 
other medicine would make so many cures; but 
exactly the reverse takes place. 

" The power of this medicine and its rapid 
action indicate that its effects should be thoroughly 
studied before using it. 

" Now, as Opium has hitherto been but little 
used, excepting as an antipathic and a palliative, 
and its primary effects only have been opposed to 
diseases, no medicine has appeared so soothing 
or has so apparently suppressed morbid symp- 
toms, although soon followed by results more 
distressing than the original disease. In short, 
nothing has caused more positive evil after appar- 
ent good. 

" In all kinds of coughs, diarrhoeas, vomiting, 
sleeplessness, melancholy, spasms, nervous affections, 
and, above all, in severe pain, Opium is indiscrim- 
inately given, on the ground that it is the best 
remedy in such cases. But its innumerable evil 
results do not appear among the primitive effects 
of Opium, which are precisely the reverse. 

" Therefore, we may easily imagine how few 
salutary and enduring effects can be obtained in 
the greater number of morbid and physical affec- 
tions ; and this is proved by daily experience. 

" If Opium has been found to cure cough, 
diarrhoea, sickness, spasms, etc., etc., in a few 
cases, it is only when these symptoms first show 



304 OPIUM. 

themselves in persons previously in good health 
and are but slight. Opium will sometimes restore 
the patient quickly to health, because, if these 
symptoms are at once destroyed, the body is re- 
stored to its former condition, and the tendency to 
their return is suppressed. 

" But, because this palliative action on slight 
and recent cases succeeds in a few instances, it 
does not follow that Opium really possesses the 
power of curing them permanently in all cases. 

"It cannot convert them into sound health 
because they are symptoms of other diseases with 
which Opium does not coincide homceopathically. 
For this reason it has seldom been used without 
injury to the patient in long-standing coughs, con- 
tinued diarrhoeas, habitual wakefulness, chronic sick- 
ness, spasms, anxiety and tremors, when they have 
been for some time established. 

" In administering Opium for these complaints, 
we see that it is on the principle of soothing, pro- 
curing a temporary suspension of suffering ; that 
subsequently it will relieve only by increasing the 
dose, which even then becomes less effective and 
at the same time creates new disease, — an artificial 
malady, still more serious and distressing than the 
first. 

" But it is yet more striking to observe that up 
to the present time the use of Opium has been 
abused by giving it in all kinds of pains, however 
deep seated and of however long standing. It 
shocks our understanding and seems like returning 



OPIUM. 305 

to the absurd idea of a universal medicine, to 
expect from it the cure of diseases totally different 
to each other. 

"All pains soothed for the moment by Opium 
return after a short time, when the stupefying effect 
is past, and very often are still more intense than 
before ; so that at last they will only yield to 
stronger and larger doses, which create in return 
other serious diseases new to the sufferer. The 
use of Opium in confirmed pain is therefore em- 
pirical and deceptive to the patient, leading him 
to attribute to other diseases the mischievous con- 
sequences that are due to it alone. 

" By treating all pains antipathically by Opium, 
we have seen the use of this drug bring on a 
train of evil consequences, — stupor, constipation, 
and other serious symptoms which appertain to 
Opium, and without which it would not be what 
it is. But persons have deceived themselves as to 
the character of these inevitable effects. Instead 
of perceiving in them results inherent in the nature 
of Opium, they have considered them as derived 
from some accessory properties which they have 
taken unwearied pains to separate from it. Hence 
the various correctives that have been tried for two 
thousand years, in the hope of soothing spasms 
and pains, without bringing on delirium or consti- 
pation ; of suppressing vomiting or diarrhoea with- 
out causing stupor ; of procuring sleep without 
heat, headache, tremors, languor, depression, and 

extreme sensitiveness to cold. 
21 



306 



OPIUM. 



" But all this is fallacious. By all these means 
Opium is only rendered less active, without chang- 
ing its nature." 

By a series of arguments and illustrations of 
this character, Hahnemann shows that the almost 
universal use of Opium is a resort to a temporary 
palliative of suffering, not to a specific for the 
cause of that suffering, whatever that cause may 
be. Whereas Opium can only be used with pro- 
priety in those diseases for which the correspond- 
ence of its symptoms shows it may be a specific 
remedy. These are very few in number. Hence 
homceopathists make infrequent use of Opium. 

Instead of an elaborate analysis of the Opium 
symptoms, I shall call attention only to a few of 
the infrequent applications of Opium, viz. : 

In apoplexy ; constipation ; lead colic ; wake- 
fulness. 

Apoplexy. The following description of the 
effect of a large dose of Opium is taken from 
Stille and Beck : 

" The head feels full and hot and sometimes 
light, there are buzzing noises in the ears, the face 
and eyes are injected, while the pupil is more or 
less contracted. Flashes of " light are apt to ap- 
pear before the eyes ; the ideas are confused and 
extravagant, and sometimes there is delirium ; 
the pulse is fuller and more frequent ; the skin is 
hot, the mouth and fauces dry; generally there 
is nausea and, in some cases, vomiting. To these 
symptoms depression succeeds. The pulse beats 



OPIUM. 307 

more slowly and often irregularly ; the head feels 
heavy and full, and all the senses lose their acute - 
ness ; the countenance assumes a stolid, stupid, 
besotted expression, produced by the turgidness of 
the features, the dullness of the eyes and the 
drooping of their lids ; there is a strong indisposi- 
tion to think or move, or, more properly, an 
inability to make any exertion, either of mind or 
body ; the speech is thick and hesitating ; the mus- 
cles of the limbs are affected with spasmodic 
movements, and, if the patient attempt to walk, he 
feels dizzy and oppressed, and staggers like a 
drunken man. 

"An irresistible propensity to sleep follows these 
symptoms, and when yielded to, the breathing be- 
comes laborious and often stertorous, while the 
general surface of the body grows pale and damp, 
and the hands and feet cold. The effects of still 
larger doses are similar, though more decided and 
not preceded by a period of excitement. They are 
giddiness, insensibility and immobility, respiration 
hardly perceptible, and a small, feeble pulse, which 
sometimes becomes full and slow. The eyes are 
shut, the pupils contracted, and the whole expres- 
sion of the countenance is usually that of deep and 
perfect repose. As the effects increase, the lethargic 
state becomes more profound, deglutition is sus- 
pended, the breathing is occasionally stertorous, the 
pupils are insensible to light, the countenance is 
pale and cadaverous, and the muscles of the limbs 
and trunk are relaxed." 



308 opium. 

These same words might be used to describe 
one form of cerebral apoplexy. 

"After death from Opium poisoning, the con- 
volutions of the brain are found to be flattened, 
the vessels of the cerebro-spinal axis and its invest- 
ing membranes are gorged with black blood, and 
the capillaries of the brain give out on incision 
minute drops of the same fluid. A serous liquid 
is usually met with in the ventricles of the brain 
and under the cerebral face of the arachnoid mem- 
brane." 

Thus both the symptoms and the post-mortem 
appearances resemble those of one form of apo- 
plexy, and it is not, therefore, surprising that 
Opium has been found a most valuable remedy in 
even apparently hopeless cases of this affection. 

It would seem that we should hope more from 
it when the apoplexy had not been preceded by 
chronic symptoms of lesion in the substance of the 
encephalon, such as would indicate a destructive 
process (softening, for example) as going on for 
some time prior to the apoplectic stroke. In such 
cases we have undoubtedly a considerable coagulum 
in the brain substance, and the case would naturally 
be almost hopeless. 

In several severe cases of cerebral apoplexy, 
with very profound coma, where Opium had entirely 
failed, Dr. J. Barker, of Brooklyn, has succeeded in 
effecting a cure with Apis. In his opinion, which 
is based on much experience with this remedy, 
Apis is a medicine of great importance in cerebral 



OPIUM. 



309 



and spinal affections, whether they manifest them- 
selves chiefly by coma or by spasms. 

Constipation. Opium produces a suspension of 
the secretion from the mucous surfaces of the 
digestive canal, e. g., the dry mouth and fauces. 
It probably, therefore, lessens the amount of excre- 
ment It also paralyzes the intestine. These two 
actions combine to produce an obstinate constipa- 
tion, an effect of Opium which is universally 
admitted, recognized, and, by allopaths, regretted. 
We are, however, enabled by it to cure certain 
analogous forms of severe constipation. 

Most prominent among these is the constipation 
from paralysis of the intestine caused by lead, and 
known as a concomitant of " painter's colic." 

Retention of Urine. It is doubtful whether 
Opium diminishes the secretion of urine, but it 
certainly does cause its retention in the bladder. 
This it does, perhaps, chiefly by blunting the sensi- 
bility of the lining membrane of the neck of the 
bladder, so that the fullness of the bladder is not 
recognized by the patient. It may also paralyze 
the longitudinal and circular muscular fibers of the 
bladder. Though the mass of the urine is retained 
and the bladder full, yet some urine may dribble 
away unknown to the patient. 

This whole condition is very different from that 
produced by Stramonium, which produces suppres- 
sion of urine, causing the kidneys to suspend their 
function. 

In retention of urine, Opium is our best remedy. 



OPIUM. 



It may occur in fever, in acute illness, or, frequently, 
after child-birth. 

Do we never use Opium as a palliative in acute 
and very painful affections for which we have not 
found a specific remedy? I have twice thought it 
necessary to do so. On each occasion I regretted 
it. It did mischief. The patients, after a tempo- 
rary relief, got worse, and then, after all, I found, 
by hard study, the proper remedy (as I ought to 
have done at first), and cured the cases, as I might 
and ought to have done in the beginning, without 
Opium, had I known enough. 

In evidently incurable diseases when the patient 
is moribund, as in cancer, etc., Opium may perhaps 
be given, but even in such cases, though there be 
no hope of recovery, it should be sparingly used. 



HELLEBORUS NIGER. 



BLACK HELLEBORE CHRISTMAS ROSE. 

BEFORE passing from this group, I desire to 
say a few words upon this drug, of which 
we know but little, — that little being, however, 
very precious. It was used by the ancients in the 
treatment of insanity, of epilepsy and of dropsy. 
It is rarely used now by allopathists. 

i. Its action on the vital force is well de- 
scribed by Hahnemann in a foot-note to the 
proving: 

"I conclude, from various observations, that 
stupor, blunting of the general sensibility, a condi- 
tion in which, with unimpaired vision, the patient, 
nevertheless, sees imperfectly and does not regard 
the objects he sees ; with the apparatus of hearing 
intact yet hears nothing distinctly nor comprehends, 
with his organs of taste in working order, yet finds 
not the proper taste in anything ; is always or 
often distraught, hardly remembers, if at all, the 
past or what has but just happened; has no pleasure 
in anything; slumbers but lightly, without a sound 



312 



HELLEBORUS NIGER. 



or refreshing sleep; undertakes to work without 
having power or strength to attend to his work, — 
these are characteristic primary effects of Hellebore." 

2. On the organic substance it acts as a pro- 
ducer of watery accumulations in various parts of 
the body and general anasarca. The peculiarities 
of its action have been described. In addition, it 
produces a severe headache, similar to that of 
Belladonna, and of Silicea as follows: 

Headache in occiput ; dull pain ; worse on stoop- 
ing, from the nape of neck to the vertex, aggravated 
and changed to burning on rising to the erect 
posture. 

The pain is so violent he knows not where or 
how to rest the head; he lays it every moment in 
a different position, at last finds it most tolerable 
when he compels himself to lie quiet and with 
closed eyes to half doze, and so forget his pain. 
Heat in the head, stupidity and heaviness, internal 
heat in the head, with coldness of the hands, etc. 

The eyelids tremble and quiver; a sensation as 
if the eye were pressed shut or out from the eye 
and yet the vision is normal. 

A bitter taste in the throat, increased after 
eating; nausea from the epigastrium, without ability 
to vomit, sometimes a feeling of nausea in the 
stomach, as if from hunger, but food is repulsive; 
pain in the epigastrium and in the region of the 
pylorus; every step is painful, increased by talking 
and by pressure, a sensation as if the epigastrium 
were drawn inward. 



HELLEBORUS NIGER. 313 

Heaviness in the abdomen; flatulence. 

Stool. The stool is mostly diarrhceic, being 
slimy and jelly-like, and yet the evacuation requires 
some urging. A hard and scanty stool is attended 
by violent cutting pain in the rectum from' below- 
upward, as if it constricted over a cutting substance. 

Frequent urgency to pass water and very scanty 
evacuation; or, as a secondary action, copious and 
easy discharge. 

Respiratory Organs. Spasmodic sneezing from 
tickling in the nose; also a similar cough, with 
dyspnoea. 

Back. A contracting pain in the loins, and a 
pain in the dorsal and cervical regions, as if beaten, 
and a stiffness. 

Exterior. Tearing in the medulla of the bones 
and in the dorsa of the fingers, where it is com- 
bined with a kind of paralytic sensation; various 
drawing and pressing pains. 

In the skin we see a general anasarca. 

Sticking boring pains in the periosteum and 
other parts of the body, aggravated by cool air 
and by physical exertion. 

The sleep is restless and full of confused dreams 
and of fantasies. 

The fever is made up chiefly of chill, without 
thirst, and with painful sensibility of the head to 
touch and motion; with drawing tearing in the 
limbs and stitches in the joints. 

The heat is chiefly in the head. 



3H 



HELLEBORUS NIGER. 



PRACTICAL APPLICATIONS. 

Hellebore has been useful in general dropsy 
when accompanied by the stupor and general 
paralysis of sensibility, of which Hahnemann's de- 
scription has been quoted. 

Its most frequent use, however, has been in 
typhoid and nervous fevers characterized by a 
similar stupor, and in the second stage of acute 
meningitis or acute hydrocephalus, when the effusion 
has already taken place. Its use in these cases 
was first demonstrated by Dr. Wahle, of Rome. 

Dr. Bahr, of Hanover, thus speaks of it: "In 
acute meningitis, Helleborus niger is one of our 
most important remedies when the exudation is 
regarded as accomplished. The exact time for its 
administration is when the reaction has become 
almost nothing, and the phenomena of paralysis 
have become more or less complete." 

This indication again throws us back to Hahne- 
mann's very comprehensive and terse characteriza- 
tion of the chief action of Hellebore, which 
comprises all that can be said of the remedy. 

The fact that Hellebore produces anasarca, 
would suggest its use in post-scarlatinal dropsy; 
and Altschul speaks very highly of it in such cases, 
particularly when the general symptoms are those 
of stupor, etc., as they often are. If, on the con- 
trary, the patient be restless, excited and erethistic, 
although weak, Arsenic will be better indicated. 
Apis, also, has been found of great value. 



HELLEBORUS NIGER. 315 

In mania of a melancholy type, with fixed ideas, 
or in mania daemonica, in which evil spirits are 
seen at night, Hellebore has been an approved 
remedy from the earliest ages. 



SILICEA. 



synonyms: kieselerde, terra- SILICEA, acidum sili- 

CIUM. 

THE proving of Silicea upon the healthy subject 
was published by Hahnemann in vol. iii. of the 
"Chronic Diseases," 1828. Additional symptoms 
are found in the " Materia Medica " of Hartlaub 
and Trinks, vol. iii., and a fragment by Wahle, in 
the " Archiv fur Homceopathische Heilkunst," xv., 
2, 87. These are all incorporated in Hahnemann's 
essay in the second edition of "Chronic Diseases." 
A proving by Ruoff was published in " Hygea," 
viii. (1838), and one by Hencke in "Allg. Horn. 
Zeitung," 55, 17 (1857). A proving of Aqua Sil- 
icata, by Becker, was published in " Hygea," xxii. 
(1847), an d a paper by Dr. Colby in "New 
England Medical Gazette" (1871). 

In our study of Silicea we shall follow Hahne- 
mann's essay in the second edition of " Chronic 
Diseases." 

SPECIAL ANALYSIS. 

1. Head. ( a.) Sensorium. Confusion in the 
head; mental exertion is very difficult; confusion 
in speaking ; it is difficult to seize the right expres- 



SILICEA. 



317 



sion ; a brief conversation causes confusion of the 
head and general lassitude ; memory is enfeebled ; 
dullness in the head without pain, as if it were too 
full of blood. 

Vertigo is a very prominent symptom. It 
occurs when the prover rises from the recumbent 
position or from stooping, or when sitting or walk- 
ing. Also when looking upward. It seems to 
come from the dorsal region up through the nape 
of the neck into the head (as does the headache 
of Silicea). The vertigo makes the prover incline 
to fall forward or to the left, and is so severe that 
he fears he shall fall. It is aggravated by motion, 
and by looking upward, and is accompanied by 
nausea. 

(bi) Headache. The headache of Silicea is char- 
acteristic. Its location is for the most part in the 
forehead, extending often to the temples and 
involving the eyes, especially the right eye and 
temple. There is also a characteristic aching and 
pain, extending as if from the back up the nape 
of the neck through the occiput to the vertex. 
Many of the pains, especially the pressing, aching 
pain, are described as affecting the whole head. 

The pains are chiefly aching, pressing ; also 
tearing and boring ; and heaviness and fullness, as 
though there were too much blood in the head. 

The headache occurs after mental exertion or 
annoyance. It is decidedly aggravated by mental 
or bodily exertion, by quick movements of the head 
or body, which convert the dull aching pain into 



3i8 



SILICEA. 



acute stabs ; by noise and by light. It is relieved 
by quiet, darkness, lying down, and, which is char- 
acteristic of Silicea, by wrapping the head up 
warmly. This condition, relieved by warmth, we 
shall meet in other Silicea symptoms. It is to be 
remarked that the relief is not afforded by simple 
pressure, as with Menyanthes, but by warmth, e. g., 
by warm-water compresses. Indeed, the pressure 
of the hat increases the occipital headache. 

The concomitants are pain in the eyes when 
the globes are revolved laterally in the orbits, chil- 
liness and nausea and vomiting. 

The similarity of this headache to that of 
Spigelia, Paris quadrifolia, Cocculus and Gelsem- 
inum, should be noted. 

The Silicea headache is mostly on the right side. 
The scalp is sensitive to touch ; the hair falls out 
when combed ; upon the scalp are itching pustules. 

2. Eyes. In the orbits, pressure and soreness; 
the eyes pain in the morning, as if they were full 
of sand and too dry ; the lids quiver ; they are 
agglutinated ; they are spasmodically constricted, 
and can hardly be opened ; there are symptoms of 
conjunctivitis, with moderate lachrymation and muco- 
purulent discharge. 

Itching in the eyes ; aching of the globe, with 
redness of the sclerotica. 

Considerable photophobia in paroxysms; muscae 
volitantes; objects confused before the eyes; throb- 
bing in the ears; shakes the eyes so that objects 
move up and down. 



SILICEA. 



319 



From the paroxysmal character of some of these 
symptoms, it would seem probable that most of the 
eye affections of Silicea are sympathetic. 

t 3. Bars. Itching, aching, drawing, pinching 
pains in the external meatus. These pains some- 
times occur, and often are aggravated, when 
blowing the nose or swallowing. The external ear 
is swollen, with discharge of fluid from the meatus, 
with hissing noise and deafness ; deafness ; noises 
of various kinds in the ears ; hard and painful 
swelling of the parotid gland. 

It would appear from these symptoms (as well 
as from clinical results) that Silicea corresponds to 
a catarrhal affection of the ear, both external and 
middle, and of the Eustachian tube, producing 
deafness. There is also exalted sense of hearing, 
probably sympathetic, with headache. 

4. Nose. Tenderness of the septum narium 
and of the end of the nose. Pressure and 
aching at root of nose. Drawing pain in root 
of nose, and zygoma. Throbbing in nostrils, ex- 
tending into the brain, with throbbing headache 
in the forehead. Fluent coryza, acrid watery dis- 
charge. Discharge of bloody mucus. Epistaxis. 
Dryness in the choanse. Morsels of food lodge in 
the choanse on swallowing. The sense of smell is 
unnaturally keen. 

5. Face. The cheeks, lips and chin are affected. 
The complexion is pale, as after a long sickness. 
From time to time white spots appear upon the 
cheek. In the malar bones and behind the ears 



320 



SILICEA. 



and in the temporo-maxillary articulation, pains of 
a drawing, tearing character, aggravated by motion 
and by touch. Painful constricting spasms in tem- 
poro-maxillary articulation, and then in the tempje. 
Itching and papular eruption on the forehead and 
nose, cheeks and lips, painful when touched. 

6. Lips. Vesicular eruption on the margin of 
the lips, smarting when touched, and very painfu 1 . 
The corners of the mouth are ulcerated. The sub- 
maxillary glands are swollen and painful to touch 
and on swallowing. 

7. Gums and Teeth, Gums swollen, sensitive 
and ulcerated. Vesicles on the gums. Dental 
ulcers, painful from contact of cold water. Tooth- 
ache, shooting and soreness, chiefly in carious 
teeth, worse at night, aggravated always by cold 
air and water, sometimes also by very hot food, as 
well as by cold, accompanied by sore gums, heat 
in head and burning cheeks. 

8. Mouth. The mouth and lips are dry (pri- 
mary, 30 hours) ; much saliva (secondary, 8 days). 

9. Taste. Bitter, foul, bloody, sour. 

10. Tongue. Sensation as if a hair lay on the 
tongue. Tongue sore at the tip, coated and numb. 
The right half is swollen. 

11. Throat. In the hard palate and in the 
velum, itching and stitches. Uvula swollen and 
elongated. 

Itching at orifice of Eustachian tube, with 
hoarseness and dry throat. Sticking pain in the 
throat, only when swallowing, the throat being 



SILICEA. 



321 



painful when touched ; sore throat as though a 
lump were on the left side of the throat. 

1 2 . CEs oph cigns. Difficult deglutition ; the food 
passes slowly into the stomach. 

13. Stomach. Sensations of weight and press- 
ure in the stomach. Pinching and griping pains. 
Gnawing sensation, relieved by lying with the 
limbs drawn up. Most of these sensations and 
many other symptoms come on or are worse after 
eating, are increased by walking, and are accom- 
panied by flatulence. 

(a.) Appetite. Unnatural hunger, especially 
toward evening, but no real appetite ; the food 
will not go down ; after eating a small quantity, 
nausea ; also a sensation of weakness in the stom- 
ach. After eating, eructations, tasteless, also acid ; 
feeling as of a stone in the stomach ; also vertigo 
without nausea ; also deafness, chilliness, palpita- 
tion, sweat of the face, sleepiness, heartburn, hic- 
cough. Aversion to meat. 

( b.) Thirst. Increased. 

14. Hypochondria. Across the stomach and 
hypochondria griping and pinching pain in parox- 
ysms for weeks. Drawing and pinching pain 
extending to hip-joints. Drawing and pinching 
pain extending from the hypochondria to the spinal 
column. 

( a.) Right Hypochondrium. Continued press- 
ure, stitches, pain posteriorly (near the renal region). 
(b.) Left Hypochondrium. Pain as if something 

would tear away. 
22 



322 



SILICEA. 



15. Abdomen. Abdomen distended and hard; 
not much flatulence. Tearing, griping and cutting 
pains, affecting chiefly the umbilical region, occur- 
ring or worse when walking, relieved by applying 
warm cloths. Pain in the inguinal region, as 
though a hernia would protrude. The inguinal 
glands are swollen and painful. Much offensive 
flatus. 

16. Stool. Constipation, with desire for stool. 
Sensation as though faeces remained in the rectum, 
which has not power to expel them. When, 
after much violent effort of the abdominal muscles, 
fasces have been nearly expelled, they suddenly 
recede into the rectum. This symptom has often 
been verified in practice. Silicea produces likewise 
diarrhoea. Stools are pappy with mucus, like 
particles of membrane ; or are fluid, scanty arid 
putrid -smelling, and are attended by a biting, 
burning sensation in the anus ; or they consist only 
of bloody mucus, with burning and biting at the 
anus. Frequent desire for stool, with chilliness and 
nausea. 

After stool, burning in anus ; pressure in head ; 
constriction of chest ; relief of colic, and great 
exhaustion ; he falls into a slumber from which 
colic wakes him. 

17. Anus and Rectum. Stitching, cutting and 
burning in rectum and anus. Stitches toward the 
genital organs. Moisture of the anus. Hemor- 
rhoidal tumors protrude with stool, return with 
difficulty, and discharge bloody mucus. They are 



SILICEA. 

very painful (sticking) and tender. Spasmodic, 
boring pain from anus up into the rectum and to 
the testes. 

18. Urinary Organs, (a.) Bladder. Pressure 
upon the bladder while urinating; burning after it. 

(b,) Urethra. Smarting and burning while 
urinating. Fine stitches continually in anterior part. 

(c.) Urine. Scanty, with yellow or red sandy 
deposit. 

(d.) Micturition. Frequent desire ; constant 
desire, with discharge by drops and burning in the 
urethra ; need to urinate frequently, every quarter 
of an hour; must get up almost every night to 
urinate. 

Accompanied by burning and smarting in ure- 
thra ; accompanied by itching in the pudenda. 

19. Genital Organs, Male. (a.) Penis. 
Pressure from the prostate forward ; prepuce 
swollen, with itching and moist eruption externally; 
redness near the corona, as if abraded, with itching. 

(b.) Testes. Pain in the right, as if indurated; 
pain at night, but only when lying. 

Hydrocele (reported by Wahle). Sweat and 
itching of scrotum ; itching and moist eruption on 
scrotum ; aching in spermatic cord, the testes 
hanging lax. 

( c.J Special Function. Frequent erections ; 
sexual desire enfeebled ; frequent nocturnal emis- 
sions ; great prostration after coitus. 

Discharge of prostatic fluid, with a difficult 
stool, or at every stool. 



324 SILICEA. 

20. Genital Organs. Female. ( a.) Vulva. Itch- 
ing, with watery leucorrhcea. 

(b. ) Vagina. Sensation like labor pains ; leu- 
corrhea copious, watery, with violent itching of the 
vulva, or following a pinching pain around umbili- 
cus on micturition ; bloody mucus immediately after 
menstruation. 

(c.) Menses first anticipate, then are increased 
in quantity. The secretion has a strong odor, 
preceded by a strong pressure and a compressed 
feeling over the eyes as of a weight, and by con- 
stipation. 

At the commencement of menstruation, parox- 
ysms of icy coldness of the whole body. During 
the menses cold feet, melancholy, anguish in epi- 
gastrium ; drawing between scapulae, only at night, 
relieved by bending backward ; strong burning and 
soreness of the pudenda, with eruptions on the 
inside of the thighs. 

After the menses, immediately a discharge of 
bloody mucus from the vagina. 

21. Respiratory Organs, (a.) Nasal Mucous 
Membrane. Frequent sneezing, which causes burst- 
ing pain in chest ; nose obstructed, cannot speak 
or breathe through it ; fluent coryza ; coryza some- 
times dry, sometimes fluent, but persistent. This 
and the cough are accompanied by swelling of the 
sub-maxillary gland, sore throat on swallowing, 
great chilliness, compelling to lie down ; then, after 
an hour in bed, great burning heat. 

(b.) Larynx and Trachea. Hoarseness; rough- 



SILICEA. 



325 



ness and dryness in the throat, with irritation, 
inducing cough after lunch. 

Sore feeling in top of larynx. 

Tickling itching in the region of the supra-ster- 
nal fossa, which threatens suffocation, until a deep 
shattering cough comes on, which lasts several 
hours, and produces pain in abdomen and throat. 

( c.) Cough. Deep, exhausting ; at first dry, 
then loose, with abundant purulent expectoration, 
provoked by tickling in the throat and supra-sternal 
fossa ; by a sensation as if a hair lay from tip of 
tongue to the trachea and produced a tickling, com- 
pelling to cough, hack and scrape ; by tickling in 
larynx at night ; excited by cold drinks (Rhus), by 
every act of speaking; by lying down at night; 
occurring chiefly at evening, and at night when lying. 

Accompanied by pain in thorax and sternum ; 
rawness of chest and throat ; vomiting of mucus ; 
pain in epigastrium. 

(d.) Sputa. Abundant transparent mucus; 
matter which sinks in water; yellowish green, 
offensive masses ; thick masses of pus ; bloody 
mucus or pure blood. 

(e.) Thorax. Pressing pain, stitches; general 
sensation of weakness in chest; weakness when 
speaking ; has to use the whole chest to utter his 
words. 

Induration in left mamma. 

(f. ) Respiration. Deep sighing ; dyspnoea ; 
better after eating. 

22. Heart. Palpitation when sitting quietly. 



326 



SILICEA. 



23. Back. Coccyx pains, as after long riding 
in a wagon ; sacral pain on standing up ; aching 
and tension and violent stitch. 

Stiffness and pain in the dorsal region ; tearing 
or aching with chill, finally passing into a dull 
headache ; rending pain between scapulae ; drawing 
pain in scapulae in paroxysms. Then it goes into 
nape of neck and head, where it becomes a ver- 
tigo, so that he feels as if he should fall. 

Pain and burning in scapulae. 

In nape of neck, stiffness, causing headache ; 
stiffness of one side of neck, preventing turning the 
head ; swelling of cervical glands ; eruption, like 
nettle-rash, in the nape of the neck. 

Swelling of thyroid body. 

24. Extremities. Upper. Pressing pain in the 
shoulder, extending to the hand, with the feeling 
as if one could not lift a heavy weight ; also at 
night in the shoulder, extending to the elbow, 
aggravated by uncovering, relieved by warm wrap- 
pings; drawing soreness in the axillary glands, in the 
hands and fingers; jerking pains in shoulders and 
arms ; sticking in the fingers, as if from splinters 
of wood ; the arms and hands are heavy, and feel 
paralyzed ; tonic spasm of the hand when writing. 

25. Lower. Similar sensations to those de- 
scribed in the upper extremities. Pains and stitches 
under the great toe-nails, very severe ; sweat of the 
feet, . especially of the soles and between the toes, 
which become abraded and sore from walking ; 
very offensive smell of the feet, without sweat ; 



SILICEA. 



327 



the limbs and feet feel very tired, and as if para- 
lyzed ; painful tonic spasm in the feet and toes 
during' a long walk. 

26. Sleep. The prover is wakeful in the even- 
ing, by reason of thronging thoughts ; the sleep is 
either frequently interrupted by frightened waking, 
or disturbed by dreams and fantasies ; at night the 
circulation is excited, with throbbing in all the 
vessels and a jerking of the whole body ; burning 
in the stomach, with nausea and vomiting of food, 
and flatulence ; anguish and restlessness ; sleep- 
walking ; nightmare. 

27. Fever in a definite form is not produced 
by Silicea. Some chilliness, especially after lying 
down at night, and heat during the night, with 
thirst ; copious sweat at night, especially toward 
morning. 

28. Skin. In many places itching or burning 
itching. Itching eruption, papular or vesicular, upon 
the chest, thighs and back. The skin is sensitive 
and irritable, and the whole body is painful as if 
beaten. Abrasions readily take on the suppurative 
process. 

In ulcers already existing, there are boring or 
aching, stitching pains, with abundant formation of 
pus. 

29. Mind. The faculties are depressed, and 
memory weakened. 

30. Disposition. Anxiety and restlessness, such 
as follow fright ; peevishness and angry irritation ; 
ill humor and contrariety, with disgust of life. 



328 



SILICEA. 



GENERAL ANALYSIS. 

1. Vital Power. Silicea manifests but little 
distinct action upon the vital powers. The senso- 
rium is somewhat depressed in its activity. The 
special senses of sight, hearing- and smell are 
exalted in connection with the headache hereafter 
to be described, but no perversions of sense are 
recorded. The peculiar pains affecting the head, 
nape of neck and the eyes, show a definite field of 
action. The muscular system exhibits only a mod- 
erate degree of depression. The sphincters are not 
affected. 

2. Organic Substance. On the other hand, 
the organic substance of the body is profoundly 
and variously affected. The mucous membrane of 
the large intestine and of the nares, pharynx and 
respiratory tract generally is affected, secretions 
being increased, and so modified in respect of, at 
least, the respiratory tract, as to resemble pus. 
Pustular eruptions appear on the skin, abrasions 
readily take on suppurative action, and ulcers 
already existing increase in size and activity, and 
become the seat of stitching, boring pains. Clini- 
cal experience abundantly confirms these deductions. 

3. Sphere of Action. The head, orbit, eyes, 
and at least the upper part of the spinal cord ; the 
nasal and pharyngeal mucous membrane, including 
the Eustachian tube and the middle ear ; the large 
intestine, the bronchial mucous membrane and the 
genital organs, the skin and the lymphatic glands, 



SILICEA. 



329 



appear to comprise the sphere of action of this 
remedy. 

4. The sensations which it produces are in the 
head and eyes, pressing, shooting and tearing ; in 
the limbs, a paralytic weakness ; in the skin, itching 
and burning itching ; and in ulcers, a sticking and 
burning pain. 

5. Periodicity. Not marked. 

6. Peculiarities. It at once appears on read- 
ing the pathogenesis of Silicea that the symptoms, 
with hardly an exception, are aggravated by cold 
and decidedly ameliorated by warmth. This is 
noticed of the headache, which is relieved by 
wrapping .the head up warmly, not by the pressure 
of envelopes, as is the case with Menyanthes, 
Veratrum and some other drugs, but by the warmth. 
It is true, also, of the abdominal pains, which are 
relieved by warmth ; of the cough, which (like that 
of Rhus) is provoked by cold drinks and relieved 
by warm ones ; and of the shoulder pains, which 
come on at night when the shoulders are uncovered, 
and are relieved by covering (in contradistinction to 
Ledum, the pains of which, at night, compel the 
throwing off of the bed covering). The only appar- 
ent exception to this statement is found in the 
aversion to warm food ; the prover can tolerate 
only cold food. 

7. Characteristics. The characteristics of Sili- 
cea are summed up as follows" by Bcenninghausen : 

"Profuse sweat of the head, the body being dry, 
or nearly so. (Rhus toxicodendron has sweat of 



33O SILICEA. 

the body, except the head.) Desponding disposi- 
tion, sensibility of the pericranium ; headache, re- 
lieved by warmth ; pale, earthy complexion ; disgust 
for meat and for warm food ; abdominal pains, 
relieved by warmth ; much sneezing, with acrid 
coryza ; going to sleep of that part of the body on 
which one lies ; unhealthy state of skin ; many 
ulcers form ; sleeplessness, on account of orgasm of 
blood; quickened pulse; chilliness, even by every 
movement." 

PRACTICAL APPLICATIONS. 

From the very year that its proving was pub- 
lished, Silicea has taken high rank as a remedy 
for cases involving profuse suppuration, causing 
abscesses to come speedily to maturity and moder- 
ating the secretion of pus. In this regard, and as 
a remedy for " simple ulcer," it has a brilliant 
clinical record. It seems to be equally applicable 
whether the suppurative process be set up in the 
cellular or muscular tissue, in a gland or in a joint. 
In fistula lachrymalis, Silicea has not infrequently 
been beneficial, sometimes completely curing. It 
compares with Natrum muriaticum and Petroleum 
in this respect. It has gained a high reputation for 
the arrest and cure of whitlow, as well as for the 
affection of the matrix of the nail, popularly called 
"ingrowing toe-nail," and to cure which the toe-nail 
is so often unnecessarily torn out. When Silicea 
fails in these cases, Graphites often succeeds. 

Silicea is a most valuable and efficient remedy 



SILICEA. 



331 



in caries and in periostitis. It is related in these 
respects to Asafcetida, Graphites and Conium macu- 
latum, and to Platinic chloride, which I have used 
successfully in two cases of caries of the tarsus, 
and for a knowledge of which I am indebted to 
Dr. Wm. S. Searle, of Brooklyn, N. Y. Its value 
in affections of the bones would naturally suggest 
its use in rachitis in children, in which the symp- 
toms of "sweating in the head only," and tender- 
ness of the surface of the body, indicate its 
homceopathicity. (Hughes.) It has been recom- 
mended from experience as a valuable remedy in 
tabes dorsalis, though not so well indicated, I 
should think, as Alumina or Ruta. Where a rem- 
edy is so decidedly indicated, and has proved so 
successful in certain defined morbid processes of a 
chronic nature, such as suppuration and rachitic 
dyscrasia, there is danger of our overlooking its appli- 
cability to more acute and transitory functional 
diseases ; we are likely to have a too limited esti- 
mate of its powers to help the sick. 

The headache produced by Silicea is so charac- 
teristic and well defined, and, withal, corresponds 
to a form so frequently met with, that it is one of 
the remedies most frequently employed by me, for 
headache. The pain involves the occiput, nape of 
the neck, vertex and the eyes, or generally the 
right eye. It is a sticking or a tearing pressing 
pain, generally beginning in the neck and shoulders 
and going upward to the occiput and vertex, and 
extending through the head to the right eye. 



332 



SILICEA. 



Its conditions are characteristic, for it is much 
aggravated by motion, noise or light, the senses of 
sight and hearing being unnaturally acute. The 
patient prefers to lie down in a dark, quiet room. 
It is relieved by warm applications to the head. 
When most violent, it is accompanied by nausea 
and vomiting, and it passes away during sleep. 
The face is pale. In its conditions of aggravation 
this headache resembles that of Spigelia, but the 
latter affects the left eye and temple rather than 
the right, and is not relieved by warmth ; but it is 
mitigated by pressure, and the pain does not come 
from the neck and shoulders. 

The headache of Paris quadrifolia (a valuable 
remedy in headache) has some resemblance to that 
of Silicea. The sensation is, however, a kind of 
tightness, as if the cerebral membranes were on the 
stretch, with pressure on the temples and a very 
painful feeling, as though a cord were stretched 
tightly from the back of the eyeballs to the center 
of the brain. This headache is aggravated by think- 
ing and relieved by pressure. The eyeballs feel too 
large for the orbits. 

The headache of Menyanthes is a pressure from 
above downward; or, in the forehead, from with- 
out inward; or, in the temples, a lateral inward 
pressure, with pressure in the eyeballs. It is re- 
lieved by compression of the head, but neither this 
nor the other remedies except Silicea has mitiga- 
tion by warmth. I mention these remedies (Paris 
quadrifolia and Menyanthes) because, like Silicea, I 



SILICEA. 



333 



believe they are not so frequently used in treating 
headache as they might be with advantage. 

In chronic bronchial affections also, Silicea is of 
value. The cough and sputa furnish characteristic 
indications, prominent among which is, that the 
cough is "provoked by cold drinks." I may add, 
from observation, that the pains, soreness and weak- 
ness of the chest, are relieved by inhaling moist 
warm air. 

In uterine or vaginal catarrh, Silicea has proved 
a valuable remedy, the occurrence and character of 
the leucorrhcea furnishing an indication. 

GENERAL VIEW OF ITS ACTION. 

In the pathogenesis of Silicea the action of this 
substance is shown to be marked, first, upon the 
nutrition, the vegetative sphere ; emaciation, loss of 
appetite, retarded digestion, constipation, sweat con- 
fined to the head, but profuse on that part of the 
body; offensive sweat of the feet, swelling and 
suppuration of the lymphatic may be cited in 
evidence. The sweat confined to the head is a 
pathognomonic symptom of rachitis, and the infer- 
ence from it that Silicea might be of service in 
this disease is confirmed by clinical experience. 
Experience has likewise confirmed Hahnemann's 
declaration that Silicea has a wonderful control over 
the suppurative process, whether in the soft tissues, 
the periosteum, or the bone itself. 

Second. Upon the nervous system Silicea exerts 
a peculiar action. With evidence of exhaustion, 



334 



SILICEA. 



furnished by sensation of weakness, paralysis, etc., 
there is an exalted condition of susceptibility to 
nervous stimuli ; the special senses are morbidly 
keen, the brain cannot bear even moderate concus- 
sion, nor the spine concussion or pressure, and the 
whole surface is unnaturally tender and sensitive, 
cold aggravates and warmth relieves. There is, 
then, an erethism conjoined with exhaustion. 

Nor is this all. This erethism, which is not 
evanescent, but endures for some time, is of such a 
nature that, while it lasts, spasm is easily induced — 
indeed, spasm often occurs without any evident 
provocation, or with only the provocation of mus- 
cular exertion and fatigue. Thus, for example, the 
sensation of weakness and the cramp in the feet at 
night and when walking, the sensation of weakness 
and the spasm of the thumb and hand when writing, 
the sensation of paralysis in the rectum and the 
spasm of the sphincter ani when making an effort 
to pass faeces, a spasm which characterizes the pecu- 
liar form of constipation observed under Silicea, and 
so often cured by it. 

Clinical experience has taught us that general 
spasms occur on slight provocation in case of this 
Silicea erethism. 

As an instance of this condition of the nervous 
system, we may cite the headache of Silicea. It 
comes on after much exertion, which has exhausted 
or worried the patient. Its seat is the supra-orbital 
region, generally the right, or the eye itself, and 
the pain extends along the base of the brain to the 



SILICEA. 335 

occiput, and down the nape. Noise, motion, light 
and concussion are intolerable. Repose, quiet, dark- 
ness and external warmth give relief. 

In subjects whose nutrition is at fault, aching 
and sharp pains in the nape of the neck frequently 
occur on the occasion of any nervous strain or 
exhaustion, and when they exist are aggravated by 
exertion or excitement. Silicea presents an anal- 
ogous symptom, with similar conditions. 

For patients, on the other hand, in whom fatigue 
and impaired nutrition produce sluggishness and 
inaction of the nervous system, Silicea is not at all 
indicated. It is, for example, very different from 
Lycopodium in this regard. 

The following clinical case illustrates the action 
of Silicea, as above described : 

August 19th, 1869, I was consulted in regard 
to A. G. W., resident in Boston ; a well-grown, 
bright-looking lad, twelve years old, of dark com- 
plexion and hair. His health had been good until 
the injury soon to be described. There was no 
inheritance of spasmodic disease. When he was 
brought to me he was suffering from epileptiform 
spasms, of which he had for three months had one 
or more every day. The history of his injury and 
its results may best . be given from his mother's 
manuscript as follows (dated March 4th, 1870): 

"On the 5th February, 1869, Albert fell upon 
the ice, making a very severe bruise directly over 
the right eye. He said, when he got up from the 
fall, he was a little dizzy, but it did not hurt him 



336 



SILICEA. 



any. That night he complained of being very 
chilly ; the next morning on rising, seemed as bright 
and well as usual, but late in the afternoon com- 
plained of feeling tired, and wanted to retire that 
night earlier than usual. The following morning 
he rose with the same tired feeling, accompanied 
by chilliness, was very quiet, and said he did not 
feel well enough to go to school. During the week 
commencing February 7th he was very quiet and 
not well, the chilliness continuing, and he com- 
plained a great deal of his eyes, which were weak ; 
and he could not look at print or anything that 
required close observation ; and at times said every- 
thing looked dark as if it was night. He also 
complained of dizziness, and felt as if his limbs 
would give out and he should fall down while 
walking. 

" After that week I do not think he complained 
of objects appearing dark, but all the other symp- 
toms continued, with pain and swelling of his 
bowels. This last symptom he did not complain 
of so much the first two or three weeks, but it 
increased very much, the bowels being swollen, 
full and hard a great part of the time, particularly 
late in the afternoon and at night. 

" I think I may safely say, it was in the early 
part of March he began to be very restless and 
uneasy, seldom getting to sleep before ten o'clock 
or eleven, or even later. The only way he could 
be induced to be quiet or lie still, was by reading 
to him. As time advanced, that would quiet him 



SILICEA. 337 

but a very short time ; he would start up suddenly, 
running through the rooms, up and down stairs, as 
fast as he could, and finally throwing himself on 
the lounge, would sink into unconsciousness. These 
turns gradually became more severe. I could 
hardly detect any change from day to day ; only 
by looking back a week or a fortnight could I tell 
that he grew worse. The attacks grew more fre- 
quent and more severe until he was rigid (every 
limb and every part of his body), his eyes became 
set, and sometimes one side of him would be con- 
vulsed, jerking and twitching. These spasms 
would vary, lasting from five to twenty minutes 
usually ; but the most severe ones were thirty 
minutes. From these he would gradually relax, 
his eyes would close gently and he seemed to sink 
into an unconscious sleep. At first he would sleep 
a short time, rouse up suddenly, and always ask 
where he had been and what time it was. 

" After a time, he would not wake from these 
unconscious turns, but would seem to pass into a 
natural sleep for the night. These spasms he had 
every night with but few exceptions after May ist. 
Commencing about six, p. m., or shortly after, and 
having from four to six spasms, and sometimes 
more, until near ten o'clock, and, during the inter- 
vals between the spasms, he would listen to read- 
ing, or be crawling over the bed, pulling the 
pillows round his neck, tossing them up, and doing 
such unnatural things, apparently not conscious. 
The latter part of July, and after, he would at 
23 



338 



SILICEA. 



times have these attacks in the day ; then they 
seemed to be brought on by over-excitement, 
extreme fatigue, or disappointment. On one or 
two occasions, while walking in the fields with his 
father, he fell down, lying a few moments, then 
recovering. 

"His appetite was very changeable all through 
his trouble ; sometimes he wanted to eat too much, 
then for a long time would have but little appetite. 

" He was very nervous, and could hardly be 
induced to sit down to take his meals ; was con- 
stantly in motion, wanting some amusement all the 
time. When going into his room to prepare for 
the night (during July and after), he would, before 
removing any of his clothing, go into these spasms. 
His mind always seemed active, bright, and quick, 
except when in these spasms, and I have not had 
occasion for a moment to think it was at all dis- 
turbed ; in fact, he seemed more keen and quick 
than before his injury. His disposition was very 
much changed. Being naturally pleasant, cheerful 
and happy, and quite persevering and firm, he 
became peevish and irritable, very persistent in his 
own way and wishes ; always unhappy if opposed, 
and seemed in this respect altogether unlike himself. 

" He continued as I have described him, appar- 
ently growing worse, until he consulted you in 
August. In about one month from that time, we 
began to hope (through fears) that he was a very 
little better; the attacks seemed lighter, more 
severe ones once in a few days, then less severe 



SILICEA. 



339 



again, the severe turns growing less frequent, with 
longer intervals between. In this way he showed 
improvement for a time, then would pass a night 
or two without a spasm ; then three or four nights, 
more or less ; the spasms diminishing in this way, 
until the last spasm he had was October 23, 1869. 
Since that time, he has been extremely nervous at 
times, and showed strong symptoms of spasms ; 
but these passed off without further trouble. Twice 
since you discharged him he has been very ner- 
vous and excitable, and on these occasions, follow- 
ing your advice, I resorted to the powders for 
nervousness (Silicea 200 ), which seemed to have the 
desired effect. At times, when tired, he seems 
more nervous and irritable than is natural ; but 
this wears off by degrees. It might be well for 
me to mention that a bath does not always affect 
him pleasantly, and quite recently he complained of 
feeling badly after getting into it, and appeared 
stupid and inactive ; not because he remained in 
the bath too long ; it seemed more the result of 
the shock when he first got into the water. 
Twice within the last two months it has affected 
him in this way. Aside from this and the ner- 
vousness, I am happy to say he seems quite well. 
In regard to medical treatment, there was no med- 
icine advised by any physician consulted, before 
yourself, but the bromide of potassium, with great 
care to be taken respecting his diet, and the quan- 
tity, quality and regularity of his meals. Our 
family physician felt that unless an operation were 



34o 



SILICEA. 



performed, his trouble would result in loss of 
intellect, and that was the only treatment that 
could save him from such an affliction. We con- 
sulted one of the first surgeons in Boston regard- 
ing it ; his opinion was, that it would not be a safe 
operation, and he did not think favorably of it 
With the bromides and plenty of exercise in the 
open air on a farm, he might ultimately be better." 

The above account was written by the patient's 
mother, March 4th, 1870, and I have quoted it in 
extenso, because of its clear description and history 
of the origin, progress and decline of the disease. 
I purpose now to supplement it from my clinical 
record, made while the case was under treatment, 
and which does not, in every particular, agree with 
the mother's narrative, made from recollection, four 
months after the last spasm occurred. I saw the 
patient at my office, for the first and only time 
(the treatment was conducted by correspondence), 
August 19, 1869. He appeared very bright and 
intelligent, responding promptly and clearly when 
questioned. His mother described the case as 
already detailed, stating, however, that on the 
steamer, the preceding evening, he had had a 
worse attack than ever, in consequence, probably, 
of the excitement produced by traveling. She 
described the attack as follows, saying it was like 
those he had had for a fortnight previous, though 
more severe and lasting longer : 

"When in the bedroom, and about to prepare 
for bed, he would fall or throw himself upon the 



SILICEA. 



341 



bed, then he would plunge head foremost on hands 
and knees and thrust his head against the bolster 
or the wall, seemingly unconscious of what he was 
doing- His friends were obliged to be ready to 
put cushions between his head and the wall or 
object against which he seemed about to plunge, in 
order to guard him from injury. If touched, 
checked, or resisted while in this condition, he 
would bite or violently resist. After a time, from 
five to twenty minutes, he would sink upon the 
bed, become convulsed, and then generally sink 
into a deep sleep. The bowels were regular. 
Urine appeared normal. Appetite capricious. 
The seat of the injury appeared swollen and 
irregular to the touch, as though there had been 
a fracture of the outer table of the cranium and 
some displacement of the fragments. He said 
that stooping for any length of time produced a 
sharp pain in the right side of the forehead _ and 
heaviness over the eyes, so that he could not keep 
them open. I noticed a symptom which had never 
before been observed, viz. : That pressure upon the 
spine, in the lower part of the dorsal region, as 
from the fifth to the ninth dorsal vertebra, pro- 
duced sharp pain in the right forehead, in the seat 
of the injury." 

His mother's attention being quietly called to 
this fact, she reported from time to time that it 
was a constant symptom so long as the spasms 
continued, and that it gradually disappeared, pari 
passu, with the nervousness, which remained for 



342 SILICEA. 

some months after the last spasm. Pathologically 
this symptom is one of great interest. The lad 
was much excited during my examination of his 
case and was quite loquacious, and on this account, 
and because of the peculiar combative disposition 
evinced in the attack of the previous night, I gave 
Hyoscyamus zo °, ordering that all other medication 
should be discontinued. 

August 26. His mother reports that his con- 
dition is as before. She notices, however, that the 
spine is sensitive at the nape and throughout the 
cervical and upper dorsal regions, even more than 
below. Pressure upon the spine produces pain in 
the head. She had not noticed these symptoms 
before, but cannot say that they have not existed. 
Her attention was never directed to them. Appe- 
tite sometimes ravenous, sometimes very poor. 
Tenderness in the epigastrium is a constant symp- 
tom. The abdomen always large and protuberant. 
Calcarea carbonica 20 °. 

Sept. 10th. His mother reports that on the 
8th he fell and struck his head in the same 
place, producing swelling and pain. He was un- 
conscious for some time after the fall. Prior to 
this his spasms had seemed to be lighter, and his 
appetite had been more regular, but his excitement 
and irritability greater. Belladonna 2 °°. 

Sept. 2 2d. He has occasionally passed a day 
without any spasm, but every few days has had a 
severe one. He is less irritable, and seems more 
like himself than since his injury. When excited 



SILICEA. 



343 



he moves his eyeballs continually, and snaps his 
eyelids together spasmodically for a short time. 
Belladonna 200 again. 

Sept. 28th. He took three doses of Belladonna. 
Had severe headache with spasms in the evening, 
and unconsciousness. His mother thought the 
medicine did not agree with him, — aggravated his 
nervousness and inclined him to spasms. She dis- 
continued it. Calcarea carbonica 2 °°. 

Oct. 9th. He improved for a few days. Then 
had more headache, and at night nervousness and 
spasms. He says it is pain in his head which 
makes him nervous, and he cannot keep still. The 
pain is sometimes in the forehead and sometimes 
in the side of the head. When the pain becomes 
very acute he passes into unconsciousness. This 
pain is in and around the seat of injury, and 
extends thence to the occiput. It is aggravated by 
motion and noise and relieved by warmth. Sili- 
cea 20 °, to be dissolved in water, a tea-spoonful every 
six hours until some effect appears. 

Oct. 19th. He has been freer from headache 
since the last report, and has not complained of 
the pain at all. 

Oct. 28th. Was quite well and free from 
spasms till the 23d, on which day, having struck his 
foot while at play, and suffered a good deal of 
pain and some excitement therefrom, he had 
a hard spasm, passing off in unconsciousness. 
His eyes have been much better. Silicea 2 °°, as 
before. 



344 



SILICEA. 



Nov. 9th. No spasms nor unconscious turns 
since Oct. 23d. No complaint of pain or headache. 
There is no longer any tenderness of the spine, 
nor pain produced in the head by pressure on the 
spine. The nervous movement of the eyes is 
slight. He continued to improve steadily, except 
for a few days toward the end of November, when 
disordered digestion seemed to produce an increase 
of irritability, which, with the indigestion, was 
speedily relieved by a dose of Nux vomica 2 °°, until 
Dec. 5th, when he complained, while taking a bath, 
that when the water touched his shoulders it caused 
pain in the forehead, in the seat of the injury. 
This aggravation was ascribed to the effect of a 
blow on the head from a falling door the preceding 
day. No other bad effect resulted. After Dec. 
4th he had only Saccharum lactis. 

Jan. 7th, 1870. Continues quite free from 
spasms, and grows steadily less irritable. No head- 
ache, pain or tenderness of the spine. Appetite regu- 
lar and normal. Digestion and sleep good. Likes to 
read, and can take a lesson of an hour in length 
without fatigue. 

Discharged, with instructions to take a dose of 
Silicea 200 in case of any unusual amount of excite- 
ment or return of pain. The lad continued to 
improve without interruption, and in October, 1870, 
appeared perfectly well and resumed attendance at 
school. No symptoms of illness of any kind had 
appeared up to Jan. 15th, 1871, nor to December, 
1871. 



SILICEA. 



345 



On a review of this case, it appears that dis- 
turbance of the circulation was apparent, in a 
slight degree, within a week after the blow upon 
the head ; that the disturbance gradually increased, 
and was then replaced by nervous irritability, con- 
joined with a sense of physical prostration and 
with disturbances of nutrition, until, nearly two 
months after the injury, the first paroxysm occurred. 
The spasms increased in frequency and severity 
until he had been a month under homoeopathic 
treatment. At what period the tenderness of the 
spine first existed we have no means of ascertain- 
ing. It continued until some time after the spasms 
ceased, declining in intensity as they became less 
severe. It is noteworthy that with all this disturb- 
ance, the intellect and the special senses were not 
blunted, but came into a condition of erethism or 
exalted activity. And, moreover, that excitement 
from unusual stimulus, or from opposition, or from 
physical injury, caused an increase of nervous 
excitement, of tenderness of the spine, of headache, 
and of disposition to spasm. These features of the 
case are in marked correspondence with the patho- 
genetic action of Silicea. 

Reviewing the result of treatment, it appears 
that the bromides, though steadily given under 
skillful direction, had no effect to diminish irrita- 
bility or control spasm. The effect of exercise in 
the open air on a farm, as recommended, was 
faithfully tried from May ist to August 19th; but 
the lad grew steadily worse, and the more he 



346 SILICEA. 

exercised, even in moderation, the worse he was. 
Of the homoeopathic remedies, Hyoscyamus prob- 
ably did no good, and was not a wise prescription, 
being based on too partial a view of the case. 
Belladonna appeared to allay the violence of the 
spasms to some extent, and to moderate the 
nervous irritability. Under Calcarea carbonica the 
digestion and assimilation, which had been much 
impaired and perverted, were nearly restored to the 
normal state. It must be noted, however, that al- 
though in these respects improvement followed the 
use of these remedies, nevertheless, while they 
were being taken, the headache and tenderness of 
head and spine steadily increased, the spasmodic 
action of the eyes and lids set in and increased, 
and the spasms, though less frequent, increased in 
severity. The irritation of the nervous centers was 
evidently not controlled, and the case assumed 
more and more the aspect of a well-established 
centric epilepsy. While, therefore, the remedies 
produced beneficial results and undeniably contrib- 
uted to the cure, they did not cover the entire 
case, and it is a question whether the ultimate 
favorable result would not have been more speedily 
attained had the Silicea been administered at an 
earlier date. This remedy I regard as the chief 
instrument in the cure. For, so soon as the 
patient came under its influence there was evident 
that mitigation of all the symptoms and their dis- 
appearance, one by one, which the homceopathist is 
wont to recognize as evidence that he has found 



SILICEA. 



347 



in his remedy a similimum to the case. The 
amelioration began at once in the symptoms 
immediately referable to lesions of the nervous 
centers. The headache ceased ; the spine became 
less tender ; pressure upon it no longer caused 
pain in the seat of the injury. The susceptibility 
which had, under other remedies, persisted coinci- 
dently with improvement in other respects, rapidly 
decreased. In a word, from the time Silicea was 
given, universal improvement began ; and it was 
scarcely interrupted until the child appeared per- 
fectly well again. 

Happily for the patient and his parents, no 
opportunity was afforded for obtaining by inspec- 
tion a certain knowledge of the organic lesions 
existing in this case. Whether, as was supposed 
by the attending physician, a depression of the 
inner table of the cranium or a spicula of bone 
protruding therefrom, produced pressure upon the 
brain, and consequent irritation, or whether a low 
grade of inflammation resulted in tissue degenera- 
tion in some part of the encephalon, must be 
matter of conjecture; other hypotheses may be 
formed. If the former, the recovery could hardly 
have been expected, and can hardly be explained. 
If the latter, then under the action of remedies a 
retrograde metamorphosis must have occurred, and 
the normal tissues must have gradually replaced 
again the degenerate substitutes. In any view v 
this was not a case in which we could reasonably 
anticipate a spontaneous complete restoration to 



343 



SILICEA. 



health. The recovery, therefore, under the admin- 
istration of homoeopathic remedies is an interesting 
phenomenon; nor is the interest of the case the 
less that these remedies were all given singly and 
in the 200th potency. 



STRYCHNOS NUX VOMICA. 



HE seed of the fruit of a large tree found in 



-L the East Indies. Whether this very power- 
ful and most useful drug was known to the 
ancients is a disputed question. It is only within 
the last 1 50 years that its value in medicine has 



Nux vomica is supposed to owe its activity to 
two alkaloids, Strychnia and Brucea; but it is 
found in practice that the action of Nux Vomica 
on the organism is not identical with that of either 
of these substances. 

Nux vomica is very bitter, and Strychnia is so 
intensely bitter that a solution of one grain of it 
in 666,700 grains of cold water still retains a 
decided and strong bitter taste. 

Nux vomica is classed among the spinants or 
tetanica, the current physiological theory of its 
action restricting it to the spinal marrow. 

When taken in very small doses, Nux vomica 
is said by Stille ("System of Materia Medica and 
Therapeutics," Phila., 1864) to " derange the diges- 
tion ; to augment the secretion of stomach and 




begun to be recognized. 



35° 



STRYCHNOS NUX VOMICA. 



mouth and of liver and pancreas. It disposes to 
frequent urination, and, when given in larger 
doses, causes retention of urine ; first, by producing 
spasm of the neck of the bladder, and ultimately 
loss of power in the muscular coat of the bladder. 
It excites uterine contraction and promotes the 
menstrual flow. 

" It acts more quickly on paralyzed muscles 
than on others (perhaps because these are with- 
drawn from the realm of volition and are affected 
through reflexion alone), and produces formication 
in the limbs, and a slight rigidity of the lower jaw 
and limbs ; a sense of heaviness and debility, 
with general stiffness of the muscles and clonic 
spasms. 

"In larger, poisonous doses, after general un- 
easiness, soreness, stiffness and heaviness of the 
limbs and joints, spasmodic symptoms set in, clonic 
spasms or violent muscular twitches, seeming like 
an electric shock. 

"Then come tetanic spasms of all the muscles, 
during which the limbs are rigidly flexed or ex- 
tended, the lower jaw firmly set against the upper, 
and the body arched as in opisthotonos. The rigid 
contraction of the respiratory muscles renders breath- 
ing laborious, or even suspends it for a time, and 
the skin becomes livid from stasis of the blood. 
The corners of the mouth are contracted, showing 
the set teeth, with foam issuing from between 
them ; the eyes stare and the brow is contracted. 

"Amid all this horrible array of symptoms the 



STRYCHNOS NUX VOMICA. 



351 



mind is not at all affected, and it is probable that 
but little pain is felt. 

" The convulsions are generally interrupted by 
periods of calm, from which, however, the least 
noise, a breath of air, or the lightest touch may 
act with the suddenness of lightning to renew the 
scene. (Stramonium.) 

" Death at last occurs either from asthenia or 
asphyxia." 

The smallest fatal dose of Nux vomica is 
three grains ; of Strychnia, one grain. 

" The anatomical lesions are not uniform. The 
muscles are rigid, all the internal organs are 
gorged with blood ;" and this is all. 

These are the effects ascribed by the most 
recent authorities to Nux vomica. They may be 
reduced by analysis into the following: 

Nux vomica acts chiefly upon the spinal mar- 
row. It affects that portion which presides over 
the reflex function of the muscular system. The 
variety of effect produced by it is this : it excites 
muscular action, causing incoherent contractions to 
take place ; deranges the normal order in which 
muscular motions succeed each other ; finally it puts 
an end to these motions altogether, producing a 
kind of paralysis. 

Our much more exact and available knowledge 
of Nux vomica is derived from a proving by Hah- 
nemann and his pupils ; a most excellent proving 
from which we make the following analysis of the 
action of Nux vomica on the healthy organism : 



352 



STRYCHNOS NUX VOMICA. 



SPECIAL ANALYSIS. 

The effects on the sensorium are as follows : 
There is indisposition to mental exertion, and par- 
ticularly to that form which involves the elaboration 
and connections of subjective ideas independently 
of external objects (subjective ratiocination). The 
prover easily errs in speaking or writing. This 
corresponds with a certain manual clumsiness. 

Vertigo is produced, with momentary loss of 
consciousness, obscuration of vision and staggering. 
It occurs more particularly while eating and imme- 
diately after eating ; when walking and even when 
lying down in bed. It resembles vertigo produced 
by alcohol ; for which, indeed, Nux is a specific 
remedy. 

Head. Nux produces, moreover, confusion and 
dullness in the head, especially in the morning 
and after meals. Also great and bewildering heav- 
iness, especially on stooping. 

The headache is pressing, tensive and drawing. 
It affects chiefly the forehead and the supra-orbital 
region ; sometimes extending through the base of 
the brain to the occiput. 

It is sometimes described as a feeling- of inter- 
nal soreness, as though one had received a blow 
with an ax. With the acute headache is con- 
joined almost always qualmishness, nausea, and 
even vomiting. 

When the prover walks, the brain feels shat- 
tered. Externally the scalp is sensitive and sore. 



STRYCHNOS NUX VOMICA. 



353 



Rhus toxicodendron has the sensation when the 
patient walks, and especially when he goes up- 
stairs, as if at every step or rising the brain were 
loose and struck against the skull ; hence worse 
from motion. China has? along with a sensation 
of great fullness in the head and outward pressure 
in the temples, a feeling as if the brain were bal- 
ancing to and fro within the cranium and were 
striking against the skull, occasioning great, pain 
and obliging one to move the head (hence better 
from motion). 

Face. The chief symptoms noted on the face 
are small papules, — some of which even contain 
pus, — isolated, occurring on the forehead, cheeks 
and scalp, a kind of acne. Nux is a remedy for 
the acne which is aggravated by eating cheese, 
although the great constipation sometimes produced 
by cheese is relieved by Colocynth. 

Eyes. Drawing and pressing pains in the eye- 
lids, the margins of which become thickened and 
sore. The lids are agglutinated in the morning. 

In the eyes themselves biting, burning and 
itching, relieved by rubbing. 

The conjunctiva sometimes becomes very red, 
and there is great photophobia. 

Clinical experience has led me to regard 

morning and forenoon photophobia as especially 

indicating Nux vomica. (See Euphrasia.) The 

patient covers the eyes or buries the head in a 

pillow in the forenoon, and looks around without 

suffering in the afternoon. 
24 



354 STRYCHNOS NUX VOMICA. 

As regards the special sense, there have been 
observed a glittering appearance just outside the 
field of distinct vision, and also black and gray 
points floating before the eyes. 

Ears. In the course of the Eustachian tube, 
an itching and tickling, inducing a desire to swal- 
low. (Gelseminum has produced and cured a similar 
tickling, compelling the prover to cough.) 

Stitches, pressure and shocks in the ear, often 
violent. Hissing and whistling in the ears, and 
sometimes a whirring and noise like that of a mill. 

The cuticle peels off from the lips ; on the 
inner part of the lips and on the vermilion border 
ulcers form, which burn and stick. 

The gums swell and pain like ulcers ; indeed 
ulcers actually form upon them, having a drawing 
and burning pain. 

The stomatitis indicating Nux vomica must be 
distinguished from that which requires Alumina, 
Borax, Carbo vegetabilis, etc., chiefly by the symp- 
toms of stomach and bowels and sleep. 

In the teeth various pains occur ; soreness in- 
creased (as all the Nux vomica pains are) by mental 
exertion, and by going into the open air. The 
pain may be throbbing, boring, drawing ; extend- 
ing into the gum, which is swollen, and into the 
bones of the face. It is worse after eating, and 
from cold water or cold air, and from exertion of 
mind or body. 

The tongue becomes heavy as if half paralyzed. 
Papules and vesicles appear on it. 



STRYCHNOS NUX VOMICA. 



355 



The mouth is dry, even without thirst, as after 
alcoholic drinks. In the morning the mouth and 
fauces are full of thick and unpleasant mucus. 

The fauces are sore as if raw ; felt on swallow- 
ing and on contact with cool air. The mucous 
membrane covering the hard palate, and the velum 
and uvula become swollen with a pressive pain felt 
particularly on swallowing saliva. There is a sen- 
sation as if there were a plug in the throat, felt 
no more when swallowing than at other times. 
Probably a gastric symptom. Pulsatilla and La- 
chesis have a similar sensation ; as if a mass of 
food had remained in the throat. 

A kind of burning in the throat and a scraped, 
raw sensation in the pharynx, as after water- 
brash. 

It is apparent that Nux does not correspond 
to angina tonsillaris or submucosa, but rather to 
a sub-acute affection confined to the mucous mem- 
brane of the palate, uvula, and pharynx. 

The taste is much altered, especially early in 
the morning. It is sour, herby or metallic, or all 
three combined ; sometimes putrid, especially after 
eructation. 

Sometimes it is bitter, especially just after 
ejecting mucus from the mouth and fauces. As 
a general thing, food and drink have their normal 
taste. 

Under Pulsatilla, food and drink very often do 
not have their natural taste. Under Natrum muri- 
aticum they have no taste whatever. 



356 STRYCHNOS NUX VOMICA. 

The appetite is generally impaired, and there is 
a general repugnance to food and to the accus- 
tomed stimuli, wine and tobacco. 

On the other hand, there is sometimes an 
abnormally great hunger. 

I have often observed that persons subject to 
frequent attacks of gastric disorder requiring Nux 
vomica have, for twenty-four or thirty-six hours 
before an attack, a wonderfully good appetite, 
especially for meat and fat. If, as soon as this 
unnatural hunger is noticed, they cut down their 
bill of fare to bread and water for one day, they 
avert the attack. 

After the midday meal, a host of symptoms of 
all kinds appears, relating to the stomach and also 
to the head and entire organism, — a general aggra- 
vation after dinner (different from Pulsatilla). 

The eructations are generally painful, as if from 
spasm of the oesophagus. In taste they are bitter 
and sour. 

Hiccough is a frequent and distressing symp- 
tom. There is a good deal of thirst, but water 
burdens and distresses the stomach. 

Nausea is a constant symptom. It occurs espe- 
cially early in the morning and just after a meal, 
and is conjoined with a kind of faintness and feel- 
ing of illness, such as is produced by a strong 
purgative. 

The vomiting is generally of sour mucus and 
food, sometimes of blood. 

The region of the stomach is very sensitive to 



STRYCHNOS NUX VOMICA. 



357 



external pressure, and so indeed is the abdomen 
generally. Tight pressure from clothing is un- 
pleasant There is a pressing pain as from a load 
in the stomach, and this even though the amount 
of food or drink taken has been very small. 

Several remedies resemble Nux vomica in these 
symptoms. Mercurius has a peculiarly deadly 
faintness produced by pressure in -the pit of the 
stomach. Calcarea carbonica has tenderness of the 
pit of the stomach. 

Lycopodium has pain in the pit of the stomach 
when the hypochondria are pressed, and pain in 
the hypochondria when the pit of the stomach is 
pressed. Lycopodium has also a sensation of 
fullness in the gastric region as soon as one has 
eaten but little, although one sat down with a good 
appetite. Lycopodium has also much flatus incar- 
cerated here and there, but it lacks the irritability 
of the large intestine so characteristic of Nux 
vomica. 

Sepia and Murex have an all-gone sensation in 
the pit of the stomach, worse about eleven a. m., 
and relieved by eating and lying down. 

The abdomen feels greatly distended and is 
moderately so ; respiration is embarrassed. These 
symptoms are all worse from walking in the cool 
air. 

There is much flatus in the bowels. Sudden 
attacks of spasmodic pain in the region of the 
stomach. 

Burning in the cardiac and pyloric region. 



358 STRYCHNOS NUX VOMICA. 

Nux produces sticking pains, and soreness and 
swelling in the region of the liver, which are 
aggravated by motion and by deep inspiration, as 
well as by pressure. 

All varieties of flatulent colic are simulated; 
griping pains, pains as if the intestines were 
squeezed between stones, etc. 

Great distention immediately after eating or 
drinking. Frequent sharp pain with desire for 
stool, ineffectual. 

Nux vomica is often a better remedy than 
Chamomilla for the colic of infants, that is, when 
it is better indicated; as by the large amount of 
flatus and by the constipation with apparent fre- 
quent desire and effort to evacuate the bowels; 
Chamomilla having, rather, a diarrhoea. 

All symptoms relieved by repose, when sitting 
or lying down. 

In the abdomen a sensation as from a load or 
burden, — a pressure or dragging toward the geni- 
tal organs, as from a constrictive cramp ; the 
abdomen is sore and sensitive. 

The following symptom is very important: a 
sensation of weakness in the region of the abdom- 
inal ring, as if a hernia would occur or were 
getting strangulated. Hernia actually appears. 
This symptom has led to the successful use of 
Nux vomica for incarcerated and other hernia. 

As regards the stool, Hahnemann remarks that 
copious diarrhceic stools are never produced by 
Nux vomica; but that what is called diarrhoea 



STRYCHNOS NUX VOMICA. 



359 



from Nux are rather small evacuations mixed with 
mucus, and attended by tenesmus and straining. 
This tenesmus is attended by a smarting burning 
in the rectum. 

The most frequent primary (?) action of Nux 
is the production of constipation, as if from con- 
striction or inactivity of the intestines, or rather, 
it produces an ineffectual urging to stool, and 
whenever at last the stool takes place, it seems to 
be incomplete and unsatisfactory, and as if a part 
of the faeces failed to be expelled ; or the stool is 
very hard, and its evacuation requires great effort, 
and leaves a stitching and aching pain in the rec- 
tum. But, after the evacuation, there is no desire 
to sit and continue to strain, as with Mercurius. 

Often, the stool is soft, mixed with mucus and 
streaked with blood ; or there is clear blood along 
with the faeces. (Dysentery and haemorrhoids.) 

In the rectum and anus, sharp, pressing pain, 
especially after mental exertion. Painful constric- 
tion of the rectum after mental effort and after 
eating. 

As regards the urinary organs: painful, inef- 
fectual effort to. pass water, with scanty discharge. 
Often, with the urine is mixed a tenacious mucus. 
Burning pain during micturition. 

The menses occur too soon and continue longer 
than they should. The inter-menstrual interval is 
too brief. 

They are accompanied by nausea, chills, and 
faintness, after previous spasmodic movements in 



3 6 ° 



STRYCHNOS NUX VOMICA. 



the abdomen. Sometimes great prostration and 
severe headaches and pains in the limbs. (Useful 
in anticipating menorrhagia and in menstrual 
colic.) 

In the respiratory tract Nux produces a variety 
of catarrhal symptoms, but none of sub-mucous or 
parenchymatous inflammation. 

The nares become sore and ulcerated, the smell 
perverted ; there seems before the nose a smell of 
sulphur, or of bad cheese or of candle-snuff. Fre- 
quent discharge of thin, acrid fluid from the nose, 
and yet the nares are obstructed. 

Much sneezing. The coryza is fluent early and 
by day ; and in the evening it is dry and so is 
the mouth. 

Coryza fluent during the day ; dry evening and 
night. 

The voice is hoarse and raw; the larynx pale, 
rough and scraped ; the prover hems and clears 
the throat constantly. There is a moderate amount 
of mucus in the throat and chest. (Coryza and 
influenza.) 

The cough of Nux is induced by motion of the 
body or exertions of the mind ; by forced expiration, 
reading, etc. ; is worse every other day ; appears 
in the evening or at night after lying down, and 
prevents going to sleep. It is short and dry but 
fatiguing; lasts often from midnight to day-break, 
and is accompanied by severe headache and pain 
and soreness in the epigastric zone. 

It is not a deep, chest cough, but seems to 



STRYCHNOS NUX VOMICA. 



361 



come from the larynx. A more important remedy 
in coughs than has been supposed. 

Respiration is embarrassed ; a kind of asthma 
worse at night and after a meal; worse from hav- 
ing the clothing tight on the thorax, relieved by 
removing the clothing. (Useful in asthma.) 

The pains in the thorax are chiefly such gen- 
eral sensations as accompany the asthma and the 
fatiguing cough just described. 

No heart symptoms. 

In the sacral region, pain at night which 
hinders turning in bed. 

Contracting and constricting pain in the sacrum, 
and thence into the sides and back and the inter- 
scapular region. 

Lassitude and pain as if beaten ; dragging and 
bearing down in the pelvis. 

In the extremities, lassitude, heaviness and 
aching and drawing pains. 

We come now to the 

GENERAL ANALYSIS. 

On the functional activity the action of Nux 
vomica is well marked. It affects the sensorium 
but little in comparison with its effects on other 
parts of the nervous system, offering a marked 
contrast to Stramonium, which produces tetanic 
convulsions resembling those resulting from Nux 
vomica, and at the same time produces violent 
mania ; whereas during the convulsions of Nux 
vomica the mind is not affected. 



362 STRYCHNOS NUX VOMICA. 

In this respect of profoundly affecting the 
organs and functions of nutrition and locomotion, 
while the mind and senses are but little affected, 
Nux vomica resembles Veratrum, Camphor and the 
poison of Asiatic cholera. 

The reflex function of the spinal marrow is 
unquestionably the great seat of action of Nux 
vomica, as the symptoms of convulsion or of semi- 
paralysis in the limbs and trunk, together with 
the spasmodic affections of the face, jaws, throat, 
oesophagus, intestinal and urinary tracts, and the 
respiratory organs, particularly the larynx, plainly 
show. 

It is an error, however, to regard the action of 
Nux vomica as restricted to this region. It acts 
with hardly less vigor upon the organic substance 
of the body ; and this more particularly in the 
entire intestinal tract and in the urino-genital 
organs, modifying the secretions in both quantity 
and quality, and causing not only perversions of 
function but also changes of structure, as we see 
in the aphthae and in the haemorrhoids which it 
produces and cures. 

The sphere of action of Nux vomica will be 
seen thus to be quite extensive, involving most of 
the functions and organs of animal and vegetable 
life. The sensorium is not deeply affected, save 
secondarily. The skin, bones and glands are not 
primarily affected by Nux vomica. 

Periodicity. There is a well-marked periodicity 
in the action of Nux vomica. As a general rule, 



STRYCHNOS NUX VOMICA. 



363 



it may be stated that its symptoms are aggravated 
in the morning. 

Peciiliarities. Among the peculiarities attending 
almost all the symptoms, and which serve as char- 
acteristic indications, are the following : 

The symptoms are worse in the morning; they 
are made worse by motion and by exertion, and 
by exposure to cool air, being ameliorated by 
repose and by warmth. In all these respects Nux 
vomica is the opposite of Pulsatilla. 

The sleep of Nux vomica is peculiar. Instead 
of being wide-awake in the evening, as under 
Pulsatilla, the prover falls asleep in his chair, is 
very heavy, and on going to bed sleeps imme- 
diately. On the other hand, an hour or two 
before day-break the prover wakens and then cannot 
sleep again, or, rather, he dozes after a while in a 
semi-conscious state, and then wakens more tired 
and inert than before he dozed. 

Under Pulsatilla there is difficulty in falling 
asleep in the evening, but the sleep is sound till 
morning, and, on waking, the patient is languid. 

Many of the symptoms occur or are aggravated 
immediately after eating; whereas under Pulsatilla 
they did not occur or were not aggravated until 
several hours after eating. 

The symptoms are aggravated by mental exer- 
tion or by sedentary habits, to which, nevertheless, 
the Nux vomica patient is disposed. 

The disposition is irritable, choleric, impatient. 
If there be despondency it is of the impatient kind. 



3 6 4 



STRYCHNOS NUX VOMICA. 



PRACTICAL APPLICATIONS. 

Hahnemann says in the introduction to the 
proving: "There are a few medicines, the greater 
part of whose symptoms are analogous to the 
principal and most common diseases to which man- 
kind is subject, at least in Europe, and which, 
consequently, are most frequently employed in 
homoeopathy. The term polychrest may be applied 
to them. 

" To this class Nux vomica especially belongs. 
The use of it was formerly dreaded because it had 
been tried only in very large doses ; and in cases 
with which it did not correspond it could not fail 
to injure. But in a moderate dose it is the mildest 
and most precious of medicines in instances where 
its symptoms accord with those it excites in 
healthy persons. 

" Nux vomica is chiefly successful with persons 
of an ardent character, or a temperament disposed 
to anger, spite or deception. If the catamenia 
occur several days too early, or are too abundant, 
Nux is perfectly adapted to meet the consequences/' 

In this respect Calcarea carbonica is similar to 
Nux vomica. Pulsatilla and Sulphur are opposites. 

"This medicine (Nux vomica), taken some hours 
before going to bed, acts more mildly than at any 
other time of day. Any case of immediate neces- 
sity must of course be excepted. 

" It is best for very sensitive persons not to 
take it fasting in the morning or on first waking, 



STRYCHNOS NUX VOMICA. 



365 



because its most powerful symptoms are then called 
out. Also, it should not be taken immediately 
before or after a meal, or when the head is much 
exercised, nor should the patient, after taking this 
(or any other) medicine, directly employ his facul- 
ties in writing, reflecting, or reading, or reciting. 
He must wait at least two hours to avert ill con- 
sequences. 

"Among the diseases in which Nux vomica is 
especially efficacious are many chronic affections ; 
for instance, those caused by excess of coffee or 
wine, especially in persons of sedentary habits; or 
those proceeding- from too protracted literary appli- 
cation. It is also a remedy for many epidemic 
disorders and acute fevers, chiefly those in which 
cold is preceded or accompanied by heat. It fre- 
quently prevents the bad effects of chills. 

"It is more particularly suitable when the 
patient is worse in the morning than at any other 
time of day; when he awakes about three a. m., and 
remains wakeful with a multitude of ideas crowd- 
ing his mind, and when, just at day-break, he falls 
involuntarily asleep, filled with busy dreams, from 
which he wakes tired and indisposed to arise. It 
is also adapted to persons who, several hours 
before bed-time, fall asleep in their chair." 

Vertigo . . Headache . . Gastralgia . Flatulent colic 
. .. Constipation .... Diarrhoea .... Dysentery ... Haemor- 
rhoids .... Hernia .... Coryza. .. Bronchitis .... Laryngesi- 
mus .... Asthma ... Bad effects of coffee and wine ... 
Intermittent fever. 



I 



ALOES. 

THE Aloe spicata, the inspissated juice of the 
leaves of which is the part used in medicine. 
It has various names denoting the origin of the 
specimen. 

1. Socotrina, the finest kind, called also Turk- 
ish or Indian Aloes, of a garnet red color with a 
golden or yellow red when powdered. 

2. Hepatic, similar but less brilliant. 

3. Cape Aloes, the most abundant, derived 
from the Cape of Good Hope, greenish and dull. 

4. Barbadoes Aloes, strong, dark brown, used 
for horses. 

Aloe has been used in medicine since very 
early days. Its great bitterness has given it repu- 
tation as a tonic, but its chief use has been as a 
cathartic. 

The ancients ascribed to it a special power to 
purge off the bile, and to cure affections of the 
abdomen and of the head, supposed to depend on 
a disordered state of the biliary secretion. 

Aloe* is a drug in very frequent use in our 
day. Very few purgative pills are ordered by 



ALOES. 



367 



practitioners which do not contain a portion of 
Aloes. It is the standing ingredient of the so- 
called anti-bilious vegetable purgative and other 
pills known as "patent medicines." Likewise of 
certain officinal mixtures, about the names of which 
there has gathered from the days of our childhood a 
certain odor of antique sanctity, to wit, the tincture 
of aloes and canella, known as hiera picra (or 
sacred bitters), and the tincture of aloes and myrrh, 
known as the elixir proprietatis (or, more commonly, 
elixir pro). 

Trousseau and Pidoux give an excellent sum- 
mary of the action of Aloe : 

" Administered in small doses (one-half grain to 
one grain) once or twice a day, it provokes moder- 
ate colics, followed by the expulsion of one or 
more diarrhceic stools. It is remarkable that the 
action of this purgative is very slow, the stool 
rarely follows within six or seven hours after the 
dose, and often not till twenty-four hours after it. 
The first effect, then, is to augment the number of 
the stools, or simply to facilitate their evacuation, 
and it likewise stimulates the functions of the 
stomach, but only where the slowness of digestion 
is not accompanied by symptoms of chronic gastri- 
tis. If the use of Aloes be continued for a long 
time, there soon ensue symptoms of sanguineous 
congestion of the pelvic organs, such as heat, itch- 
ing, sensation of weight toward the extremity of 
the intestine, excitation of the genital organs, and 
frequent need to evacuate the bladder. In women, 



3 68 



ALOES. 



pain and heaviness in the uterus, in the groins and 
in the loins, increase of the leucorrhcea, uterine 
colics, more painful during the menses, increase of 
the menstrual flow." 

Aloe has been known, in numberless cases, to 
produce congestion of the lower part of the rectum, 
with haemorrhage from the haemorrhoidal veins. 
And the tendency to this action is a great objection 
to the customary long-continued use of this drug 
as an habitual palliative in constipation. Neverthe- 
less, Aloe has been successfully used by Eberle in 
the treatment of haemorrhoids. 

By reason of its power to cause congestion of 
the pelvic organs, Aloe has been used by the old 
school as a derivative in cases of severe cerebral 
congestion, also in amenorrhcea (particularly the 
tincture aloes et myrrhae or elixir pro). 

Our direct knowledge of Aloes is derived from 
a proving conducted by Dr. Hering (and published 
in his " Amerikanische Arzneipriifungen," vol. i.). 

A most excellent, accurate and spirited transla- 
tion of this admirable proving will be found in the 
appendix to vol. v. of the " American Homoeopa- 
thic Review." It was executed by Prof. T. F. 
Allen, A. M., M. D., of New-York, and is a model 
of philological discrimination, avoiding at once the 
indefinite and flippant gracefulness of modern Eng- 
lish, and the corduroy roughness of colloquial Ger- 
man; combining the acerb crispness of rugged York- 
shire with the Amherst softness of highly civilized 
southern Saxony. 



ALOES. 



369 



As already stated, the action of Aloes is chiefly 
exerted upon the pelvic organs, in which it pro- 
duces functional changes (in so far as the secretions 
are concerned in frequency and manner), and 
organic in this that the organs are gorged with 
blood. 

The action upon the head I believe to be 
secondary upon the action on the pelvis. I have 
never seen it disassociated therefrom. 

The peculiarities of Aloes will appear in the 
special analysis. 

SPECIAL ANALYSIS. 

On the sensorium Aloe produces a singular 
combination of anxious restlessness, despondency, 
indisposition to mental or bodily exertion, and 
confusion of the intelligence. These conditions 
alternate, but the depression is predominant. 

Considerable vertigo is produced, which, how- 
ever, coincides with constipation or other disordered 
condition of the intestine and its functions. 

It resembles the vertigo of Chelidonium, which 
coincides with pain in the right hypochondrium and 
at the angle of the scapula, and with icteric com- 
plexion and bilious urine. 

The headache of Aloes is chiefly a confused 
feeling of heaviness or pressure in the anterior 
part of the head, a weight pressing down the mid- 
dle of the forehead to the root of the nose. The 
pressure sometimes extends to the vertex, some- 
times to the temples. Sometimes throbbing. Most 
25 



3 JO ALOES. 

provers note that this headache accompanies or 
alternates with colic or constipation, or with the 
kind of diarrhoea peculiar to Aloes. 

The scalp becomes sensitive to touch. Respect- 
ing the eyes, we note here only a symptom which 
often accompanies the pressing frontal headache, 
viz., pressure on the eyes from above and a feel- 
ing as if it were necessary to contract the eyes 
and make them very small in order to see (symp- 
tom 172). I have prescribed on the authority of 
this symptom Aloes for a patient whose other 
symptoms were not very clearly indicative of Aloes, 
and thereby succeeded in permanently curing a 
chronic headache. 

I call attention to the ear symptoms in the 
published proving, because Dr. Hering has found 
Aloes to be a good ear remedy. I have no expe- 
rience with it as such. 

Hypochondria. In the hepatic region we find 
pressure and tension, discomfort, a sensation of 
heat, pressure, and single not severe stitches. 
These symptoms, along with the sickly expression 
of face and the bitter taste, point to some derange- 
ment of the liver, though, from the absence of 
fever in the Aloes proving, it cannot be acute 
inflammation. Eberle signalizes the efficacy of 
Aloes in certain forms of. jaundice. 

(Lycopodium has tension and pressure, but 
these are felt in the left as well as in the right 
hypochondrium, and are aggravated by pressure on 
the epigastrium. China has symptoms in the right 



ALOES. 



371 



hypochondrium, similar to those of Aloes, but is 
distinguished by the fever symptoms and others. 
The Chelidonium liver symptoms are accompanied 
by pain under the right scapula, and generally by 
cough,) 

The abdomen is somewhat distended with flatus. 
There is head fullness, a sense of weight and 
dragging, particularly in the hypogastrium, and the 
abdomen is tender on pressure. 

The heaviness extends into the rectum and into 
the region of the bladder. Flatulent colic accom- 
panies the pelvic congestion. 

As regards stool, it is first, by very small 
doses, retarded and diminished. Then it is more 
free ; finally there ensues a half-fluid, light yellow, 
moderately offensive stool, and at last a yellow 
watery diarrhoea. 

The peculiarities of the evacuation characterize 
this drug. The diarrhoea comes on early in the 
morning, say at five a. m. The desire for stool 
wakens the patient, and he can hardly rise with 
sufficient rapidity. In this respect Aloe resembles 
Sulphur, Thuja (and Bryonia). 

Croton tiglium has a morning diarrhoea, light 
yellow, watery, almost painless, very abundant, 
gushing out in an instant, imperative, leaving 
prostration. 

Sulphur diarrhoea is white mucus, watery, pain- 
less, containing undigested food ; the patient has 
to get up to go to stool. 

Thuja, pale yellow, forcibly expelled, with much 



372 ALOES. 

wind. It returns at the same hour but is not 
imperative. 

Bryonia, dark and putrid, smelling like old 
cheese. Only a. m. 

But with Aloes there is throughout a peculiar 
sensation of weakness in the rectum, and particu- 
larly in the sphincter ani, as if the latter would 
be suddenly relaxed in spite of the patient's will, 
and would permit the escape of faeces. 

The diarrhoea rarely continues later than ten 
a. M. The disposition is always brought on by 
eating, e. g., at the breakfast table. 

So treacherous does the sphincter ani seem to 
be that the emission of flatus is dreaded as sure 
to be accompanied by the escape of faeces. (Sim- 
ilar to Phosphoric acid.) So likewise the patient 
dreads to pass water lest the slight exertion and 
bearing down involved in that act should also 
move the bowels. 

A very similar state of things obtains with 
regard to the sphincter of the bladder. 

At the same time there is a frequent disposition 
(as with Nux vomica) to evacute the bladder and 
rectum. 

At the extremity of the rectum, burning, itch- 
ing. Bleeding from the rectum. 

In the perinaeum, a sensation of weight and a 
feeling as if a plug were wedged in between the 
symphisis pubis and the os coccygis. 

Hepar sulphuris, Thuja and Causticum have 
similar sensations pointing to affections of the 
prostate gland. 



ALOES. 



373 



In the pelvis, heat, weight, pressure and drag- 
ging" downward. 

The menstrual flow is augmented and hastened. 

The practical applications of Aloes follow clearly 
from the statement of symptoms. Experience has 
thus far established its value in the treatment of 
diarrhoea, headache and vertigo depending on pel- 
vic congestion, haemorrhoids, prolapsus uteri and 
menorrha^ia. 

The symptoms which have seemed to me the 
most characteristic are those of the head and of 
the abdomen, stool and urine. They are those on 
which my use of Aloes in practice has been based. 
Chief among these are those of the stool. 

From symptoms 512 to 860, we gather that 
Aloes produce a diarrhoea consisting of light- 
colored semi-liquid faeces, preceded and accom- 
panied by much gurgling and flatus in the 
abdomen ; that the diarrhoea occurs , especially in 
the morning, say from two a. m. to ten a. m. ; that 
the desire for stool is sudden and extremely urgent, 
being felt in the hypogastrium and in the rectum, 
and being so urgent that the patient can scarcely 
retain the faeces long enough to effect the neces- 
sary strategic "change of base;" that, during this 
brief interval, he fears to evacuate wind by the 
anus or to make any physical exertion, or even to 
strain to pass water, lest he should have an invol- 
untary evacuation of the bowels. This sensation of 
the uncertain tenure by which the faeces are held 
in the rectum is a very well marked characteristic 
of Aloes, as shown by the following symptoms : 



3 74 ALOES. 

"The evacuation takes place without any exer- 
tion on the part of the patient; it seems, as it 
were, to fall out of the rectum (765). At stool 
a constant feeling as if there were more faeces 
to be passed (769). Involuntary passage of faeces 
when emitting flatus (824). Disposition to stool 
when passing water (826). Faeces and urine seem 
inclined to pass and do pass simultaneously (827). 
When passing water feeling as if a thin stool 
were about to pass (828). When standing, sensa- 
tion as if faeces would pass (833)." 

There is also a similar frequency or urgency 
of the desire to pass urine, with a similar uncer- 
tainty in the tenure of that excretion, as we 
perceive from the following symptoms: 

"Frequent desire to urinate (990). Increased 
desire — quantity not increased (992). So urgent a 
desire he can hardly retain the urine (993). On 
rising he was obliged to run quickly to urinate 
(996)." 

And the similarity of the affection of the urinary 
organs and the intestines is shown in symptom 
1001 : 

"At stool, urination; when urinating, desire for 
stool." 

In connection with these two series of symp- 
toms, those of the pelvis deserve notice. Among 
them we find, "heaviness, pressure downward (865, 
861). Feeling as if a plug were wedged in be- 
tween the symphysis pubis and the os coccygis 
(860)." This is equivalent to a weight upon the 



ALOES. 375 

perinaeum. Viewing- it in combination with the 
symptoms of stool and urine above referred to, we 
are justified in saying of Aloe, in regard to this 
portion of its sphere of action, that it strikes the 
patient equally " between wind and water." 

It is understood, of course, that this is not the 
only action of Aloes upon the abdominal organs. 
It is believed, however, to be that variety of action 
which is most characteristic of the remedy and 
least likely to be confounded with the effect of any 
other drug. In the frequent desire for stool ; in 
the frequent, pappy, not very abundant stool ; in 
the pressure downward in the back and pelvis ; in 
the abundant formation of flatus in the abdomen, 
which rumbles and gurgles, producing pinching 
pain in the lower part of the abdomen just before 
the stool, the action of Aloes very closely resem- 
bles that of Nux vomica, a remedy so useful in 
diarrhoea and dysentery. It is distinguished, how- 
ever, by the peculiarities of the evacuation of stool. 
Nux vomica produces very frequent desire for 
stool, with inability to evacuate the faeces. Under 
Aloes, on the contrary, the difficulty is to retain 
the faeces as long as the patient desires to do so. 
Aloes seem to paralyze the sphincter ani to a 
certain extent, Nux vomica to excite in it a 
spasmodic action of exalted power. In this notion 
on the sphincter, Aloes resemble Hyoscyamus. 

Among the symptoms of the head I am in- 
clined to regard as characteristic of Aloes, those 
which describe a heavy, confused dullness in the 



376 



ALOES. 



front part of the head extending to the root of 
the nose, with inability to think ; a pain in the 
forehead which compels the patient to close the 
eyes or, if he wishes to look at .anything", to con- 
stringe the eyes, making the aperture of the lids 
very small. It must be admitted, however, that 
symptoms so similar to these are found under 
other remedies, that these symptoms alone could 
not be regarded as a sure indication for Aloes. 

The following cases will show how I have pre- 
scribed Aloes, and will suggest some reflections 
upon the mode of selecting remedies in practice. 

Within the last three years I have treated 
about thirty-five cases which so closely resemble 
each other in their characteristic elements, that the 
description of all may be given in that of the last 
of the series, which came under my care a month 
ago. 

A young man applied for relief from a diar- 
rhcea which had persisted about two weeks in 
spite of various remedies which had been pre- 
scribed for it, and among which were Calcarea, 
Nux vomica, Bryonia, and the inevitable Arseni- 
cum. He described his stools as being light yellow, 
pappy, somewhat frothy, and tolerably abundant. 
They were preceded by flatulent rumbling in the 
abdomen and by pinching pain in the hypogas- 
trium. The necessity for a stool awakened him 
from a sound sleep about three a. m. From this 
hour to nine a. m. he had from four to six stools 
of the character above described. None at any 



ALOES. 



377 



other period of day or night. When the desire for 
stool was felt, the urgency became instantly so great 
that he was compelled to spring from the bed and 
hasten to the water-closet. Yet this urgency was 
not of the nature of tenesmus, but rather a sensa- 
tion of weakness in the sphincter, as though he 
could not prevent the faeces from falling out. 
During stool, which passed freely in a mass the 
instant the restraint of the patient's volition was 
withdrawn from the sphincter ani, there was a 
slight burning in the rectum. After stool, cessa- 
tion of pain, but a very slight general sensation 
of weakness and lassitude. 

During this period, from three to nine a. m., 
the patient was compelled to avoid all rapid or 
severe exertion of body, and especially straining to 
pass water. The penalty of such exertion or 
straining was sure to be an involuntary evacuation 
of faeces. 

I prescribed one powder of Saccharum lactis 
containing two globules of Aloes 200 to be taken 
dry on the tongue at ten a. m. (the hour at which 
he called on me). From this time he had no 
diarrhoea. The next morning he slept until seven 
a. m., and at nine had a natural stool as was his 
habit in health. 

During the winter season, a gentleman about 
seventy years of age applied for relief from a dull, 
heavy, frontal headache, which incapacitated him 
from mental labor. He could give me no more 
definite nor characteristic description of his ailment. 



378 ALOES. 

It was felt as soon as he waked and lasted all 
day. From such a description as the above, it 
would be impossible to prescribe with any certainty 
of selecting the right remedy. I set myself, there- 
fore, to investigate the patient's previous history, in 
the hope of getting some help from the Anamnesis 
to which Hahnemann and Bcenninghausen attach so 
much importance. I learned that this headache was 
no new affliction. It had for years annoyed this 
gentleman, rather more during the winter season, 
whereas during the summer he was comparatively 
free from it. No peculiarity of diet or regimen 
could explain this fact. 

On the other hand, I learned that during the 
summer season my patient was very frequently 
attacked with diarrhoea, the disease coming on 
suddenly, waking him at two a. m., with a pinching 
flatulent colic, and so urgent a call to evacuate 
the bowels that he would be compelled to seek 
the water-closet instantly, experiencing, meanwhile, 
the greatest difficulty in retaining the faeces. 
From this time till ten a. m., he would have 
four or five stools, pappy, copious, light yellow, 
great difficulty in retaining the faeces for even a 
moment after the desire for stool was first expe- 
rienced. Desire for stool provoked by eating, so 
that he was compelled to leave the breakfast table. 
Involuntary stool when straining to pass water. 
When comparatively free from headache he was 
inclined to diarrhoea, and vice versa. 

I have long been persuaded that a most im- 



ALOES. 



379 



portant condition of success in the treatment of 
chronic diseases, consists in the practitioner taking 
such a view of the case as shall combine the 
various ailments of which a chronic patient may 
complain at different periods of time and in differ- 
ent organs, even though these periods and organs 
be remote from each other and apparently discon- 
nected. In no other way, it has sometimes seemed 
to me, could the characteristic indications of the 
remedy for such a case be found. 

Acting upon this persuasion in the case in 
question, I regarded the headache which predomi- 
nated in winter, and the diarrhoeas which predomi- 
nated in summer, as in some sort complementary 
series of symptoms, and as making up, both 
together, the -"totality of symptoms" for which I 
was to seek, in the materia medica, the simili- 
mum. 

The symptoms of the headache — indeed of 
the entire winter affection — presented nothing 
that was characteristic of any one remedy to the 
exclusion of all others. Carbo vegetabilis, Saba- 
dilla, Sulphur, Aloes, Nux vomica, and several 
others, might be regarded as about equally well 
indicated. 

When, however, to the head symptoms of the 
winter I came to add the diarrhoea symptoms of 
the summer, regarding the sum total as one dis- 
ease, it was then impossible to avoid perceiving 
that the diarrhoea symptoms were strikingly char- 
acteristic of Aloes, and could not indicate any 



3 8o 



ALOES. 



other remedy. This furnished the clue to the pre- 
scription. On studying the head symptoms of 
Aloes, it was seen that they corresponded to the 
head symptoms of my patient quite as well as the 
symptoms of any other drug. Aloe 200 was given, 
and it afforded a relief which my patient had 
sought in vain from other remedies taken on the 
strength of the head symptoms alone. The head- 
ache returned a few times afterward with very 
much diminished severity, but yielded at once to 
Aloes. Latterly, my patient has been entirely free 
from it, nor did the diarrhoea return as it used 
formerly to do whenever the headache ceased to 
prevail. 

In a third case I have given Aloes for inconti- 
nence of urine in an old gentleman who has 
enlarged prostate. The prescription was based on 
the fact that he is very subject to a diarrhoea, 
presenting all the characteristics of the Aloes 
diarrhoea. The peculiarities of the incontinence, 
moreover, correspond to those of the Aloes urine 
symptoms. Thus far, the success of the treatment 
leaves nothing to desire. But as the patient has 
been but a few weeks under the treatment, it is 
too soon to express a decided judgment or to 
entertain sanguine expectations of a cure. 



SULPHUR. 



WE use the sublimed Sulphur (fibres sulphuris), 
triturated with sugar of milk, and then pre- 
pared in dilutions, in modo Hahnemanni ; or else a 
tincture prepared with alcohol. It is an ancient 
remedy, first mentioned as employed to purge the 
cities of Sodom and Gomorrah. 

Ulysses used it to purify his palace by fumiga- 
tion, after his terrible slaughter of the suitors who 
infested it. 

(And perhaps the modern Ulysses may be able 
in like manner to purify the White House of the 
office-seekers and parasites who haunt it.) 

Hippocrates and Pliny mention it. Pliny praises 
it in lumbago, and in lichen and prurigo of the 
face. And he says it cures cough with purulent 
expectoration and dyspnoea. Dioscorides speaks of 
its power to cure cutaneous eruptions, and espe- 
cially itch. 

Modern allopathic writers hold it in very mod- 
erate esteem. They ascribe to it first an exciting, 
but ultimately a depressing action ; the peculiarity 
of exciting diaphoresis, and of producing semi- 



3 82 



SULPHUR. 



fluid stools ; also, according to Giaccomini, brown- 
ish spots on the skin, and various ephemeral 
cutaneous eruptions. Its virtues as a specific for 
scabies they consider to depend upon its power to 
kill the acarus scabiei. 

Hahnemann's extensive proving, published in 
the fifth volume of his chronic diseases, has been 
singularly confirmed by an elaborate proving made 
by the Austrian Homoeopathic Society, under the 
leadership of Dr. Wurmb, and published in 1857. 

We proceed at once to the 

SPECIAL ANALYSIS. 

Sensorium. Vertigo. This is most apt to 
occur in the morning, and is often accompanied 
by nose-bleed, although sometimes, like many other 
Sulphur symptoms, it occurs in the evening or at 
night when the patient is in bed. It is produced 
or aggravated by stooping and by walking in the 
open air, and by looking upon objects in rapid 
motion. 

Much confusion and bewilderment of the sen- 
sorium. The memory is weakened. 

Head. Headaches are not of an acute character. 
Sulphur unquestionably produces congestion of the 
head, and the headaches correspond to this condi- 
tion. The pains are : 

Heaviness, making every motion irksome, not 
only walking and stooping, but even motion of the 
head when sitting and lying. Pressing generally 
in the forehead and over the eyes ; sometimes 



SULPHUR. 383 

general, as if the head were encircled by an iron 
hoop ; generally worse at night. Mercurius has a 
similar symptom. 

The headache is often attended by nausea. 
The hair falls out. The forehead is covered with 
acne. 

Eyes. The lids swell, the margins are inflamed, 
are thickened and sore. They burn, are worse 
after washing. This aggravation after washing is 
characteristic of Sulphur. 

In the eye, heat or a biting burning, as from 
Ammonia. Moderate photophobia. The conjunctiva 
is reddened. Vision is perverted ; there are sparks 
before the eyes and a red wheel appears to encir- 
cle the candle flame. White or dark spots float 
before the eyes, and objects are not seen distinctly. 

Ears. Tearing pains in the ears. Stitches 
which likewise involve the parotid gland. Ringing, 
hissing and swashing noises in the ears. Transient 
deafness. Sometimes connected with the heavy head- 
ache there is over-sensibility of the auditory nerve. 

Mouth. The gums swell ; sometimes bleed. 
The teeth seem too long and loose, and pain in 
biting. Similar to Carbo vegetabilis and Lycopo- 
dium. Burning pain in the tongue, and burning 
vesicler; upon it. Sometimes it is covered with an 
aphthcus deposit. The tongue and mouth are 
coated with saltish mucus. There is dryness with 
thirst. (Unlike Pulsatilla.) 

Throat. Burning, sensation of swelling, and 
constriction of the fauces. 



3§4 



SULPHUR. 



Taste. Sweetish or flat, sometimes bitter, which 
is relieved by eating. 

Appetite. Impaired. Aversion to meat and 
bread. Great and continued thirst. 

Gastric Symptoms. Oppression after eating. 
Flatulence, lassitude, eructations putrid or sour, or 
tasting of the food. Waterbrash is a common 
symptom. Nausea and sometimes vomiting. 

Stomach. Sulphur produces (and cures) a kind 
of stomach cramp ; severe, griping pain in the epi- 
gastrium, with tenderness of the stomach and liver. 

Abdomen. Pressure, stitches, in the upper part 
and sides of the abdomen ; the stitches are aggra- 
vated by deep inspiration, by walking, and are 
conjoined with a sensation of burning. 

In the region of the liver stitches from within 
outward. Feeling of tension and pressure in 
hepatic region and throughout the abdomen, with 
great depression of spirits. Burning in the abdo- 
men worse by motion. Sensation in the abdomen 
of soreness or of internal rawness ; worse on mo- 
tion and deep inspiration, as well as at night. 

Sensation of pressure downward and outward 
in region of the abdominal ring, with soreness and 
bruised sensation, not suffering the pressure of the 
hand. 

Pressure in the hypogastrium and pubic region. 

Stool. Before the stool, aching in the abdomen 
and intestines. 

During the stool, nausea, heavy headache, pain- 
ful pressure in the rectum. 



SULPHUR. 



385 



After the stool, sensation of soreness and weak- 
ness in the intestines ; general lassitude ; pressing 
pain in the rectum and at the anus. 

Sulphur constipates, with frequent ineffectual 
tenesmus, both before and after stool, and constant 
pressing, even at night, followed by aching and 
sticking pain in the rectum and anus, often very 
severe and distressing. It appears, then, that, 
instead of inaction of the lower bowel, we have 
congestion, irritation of the muscular fiber and 
irregular, inharmonious action, resulting in tenes- 
mus, and likewise hyperesthesia. 

Sulphur has a yellow or whitish mucus or watery 
diarrhoea, painless, almost involuntary, compelling 
one to rise early in the morning, and containing 
undigested food. Similar to Aloes, Bryonia and 
Podophyllum. Moreover, it produces a diarrhoea 
consisting of mucus streaked with blood, and pre- 
ceded by colic, and attended by tenesmus and pain 
(like dysentery). It is characteristic that the blood 
is in thread-like streaks. Thus, it appears that 
whether the mucous membrane of the rectum and 
colon discharge bloody mucus or be unnaturally 
dry (whether there be constipation or the so-called 
diarrhoea), the inharmonious muscular action, irrita- 
tion and hypersesthesia are the same. The charac- 
ter of the evacuation does not afford a basis for 
division of symptoms into primary and secondary, 
and for a law of dose resting upon it. 

There is also constipation, which, however, is 

always attended by fullness, heat or itching at 
26 



386 SULPHUR. 

the anus and in the lower part of the rectum, 
whereas the constipation of Veratrum and Opium 
is simple inaction of the rectum, without concom- 
itant symptoms. 

In the rectum, burning and throbbing, with 
moist haemorrhoids; itching and soreness. 

Urinary Organs. The secretion is increased in 
quantity ; evacuation frequent at night. The desire 
comes suddenly, and is imperative ; if not gratified, 
the urine passes involuntarily ; the stream is forcible. 

This resembles Aloes. 

Hepar sulphuris has the opposite, which is 
highly characteristic of that drug, and often an 
indication for it in affections of other organs of the 
body, e. g, the stream of urine is slow to start, 
and very feeble and sluggish, falling in a right 
line rather than describing an arc. 

The act of micturition is often preceded by 
cutting pains in the hypogastrium. 

At the end, and after the act, cutting in the 
urethra. Also burning, tearing and biting in the 
urethra during the act. 

Sexual Organs. Male. Inflammation of the. 
orifice of the urethra and of the prepuce, which is 
thickened and red, and burns. In the testes, 
stitches and tension ; sexual desire is increased. 

Female. Menstruation appears to come too 
soon, and to be increased in quantity. It is pre- 
ceded by various pains and symptoms, e. g., dry, 
evening cough, colic, toothache, and accompanied 
by abdominal cramps. 



SULPHUR. 



387 



This, however, is not the only action. Men- 
struation is likewise delayed or suspended, and this 
symptom, if accompanied by the night restlessness, 
constipation and other symptoms characteristic of 
Sulphur, affords a very valuable indication in practice. 

I have often found Sulphur successful where 
menstruation was suppressed, whether by cold dur- 
ing a previous period, or by unknown causes, and 
where Pulsatilla had been given without effect. 
Indeed, I think it more frequently indicated in 
amenorrhcea than Pulsatilla. 

Concomitants of menstruation are nose-bleed, 
rush of blood to the head, and pressure in the 
epigastrium. 

Leucorrhcea which follows menstruation is yel- 
low and acrid and thick. 

Respiratory Organs. Nasal Membrane. Sneez- 
ing and violent coryza, alternately fluent and dry. 
The dryness predominating, with a troublesome 
obstruction of the nostrils, relieved temporarily by 
the occasional discharge of masses of thick mucus. 

Throat. Rawness in the fauces, with hoarseness 
amounting at times to aphonia; at the same time 
there is much mucus in the bronchi, and this moving, 
with the respiration, produces a disposition to cough. 

Cough. In general it is dry ; occurs at night 
as well as by day. It is provoked by irritation in 
the region of the ensiform cartilage. 

It produces soreness and shocks in the epigas- 
trium and in the hypochondria. Besides this dry 
cough, there is a loose cough, provoked by the 



388 SULPHUR. 

movement of mucus in the air-tubes, the sputa being 
thick, yellow and sometimes sweetish. The cough 
is often forcible, causing headache and gagging. 

Dyspnoea. Considerable, especially at night ; 
comes on suddenly on turning on the left side, 
relieved by sitting up. Lassitude and great heavi- 
ness in the chest. 

Like the congestions and orgasms of the blood 
in the head, are the corresponding affections of the 
chest. They occur at night, and are aggravated 
by motion, and accompanied by heat and burning 
in the chest. The chest is sore externally. 

Back. Lassitude, heaviness, soreness ; the pains 
in the lumbar region are worse on walking, and 
especially on rising from a seat, than when sitting 
or lying. In the lumbar region, a peculiar stiffness 
and a sudden loss of power on attempting to move, 
have led to the successful use of Sulphur in certain 
forms of lumbago. 

Rhus toxicodendron and Petroleum have similar 
symptoms. Ruta and Staphysagria are indicated 
in a lumbago which is worse in the morning, 
before rising, and better after rising. That of 
Staphysagria compels the patients to get up at 
an unreasonably early hour. 

Extremities. Lassitude, heaviness, burning. 
Induration of the axillary and inguinal glands ; 
swelling of the hands and feet, with heat and 
tingling ; soreness, tension in the muscles, and 
especially in the aponeuroses, and inability to move 
them. The pains are worse at night. The skin 



SULPHUR. 



389 



of the extremities, especially of the hands, presents 
a vesicular eruption, which discharges a yellowish 
water, and itches, being very sore when scratched. 
The skin chaps, and cracks at the joints. Ulcera- 
tion at the sides and roots of the nails. Itchino- 
pustular eruption upon the elbow joints and backs 
of the hands. 

PRACTICAL APPLICATIONS. 

In the case of Sulphur has been made the first 
and only successful generalization in the way of 
indication for treatment based on pathological 
anatomy. It was made by Dr. Wurmb, of Vienna, 
in his studies of pneumonia (1852). 

Speaking of Sulphur in pneumonia, he says : 

" If the pneumonia be not complicated with 
other diseases, then generally there comes a period 
when the febrile storm subsides ; the pains, the 
dyspnoea, etc., cease. In short, the patient feels 
himself greatly relieved so soon as the infiltration 
has become complete. At this period Art can 
have no other problem than to support Nature 
while she, for the sake of removing the exudation, 
increases the activity of the processes of absorp- 
tion ; or, on the other hand, to oppose Nature, in 
case she shows a disposition to get rid of the 
pneumonic infiltration by a purulent degeneration. 

"Now, in our view, no remedy yet proved cor- 
responds so well to these indications as Sulphur; 
none compares with it in point of certainty and 
celerity of action. 



39° 



SULPHUR. 



" Sulphur penetrates the entire organism even 
in its finest and most recondite portions. It in- 
creases the activity of vegetative life generally, and 
of the processes of secretion and absorption in 
particular. It accelerates the interchange of ele- 
ments and makes it more pervading ; in a word, 
it fulfills all the demands upon which the removal 
of an abnormal product is conditional. Upon these 
grounds we apply Sulphur to the removal of pneu- 
monic infiltration, of serous exudations, and of old 
as well as recent deposits in the skin, the paren- 
chyma, the joints and the bones." 

This masterly generalization is justified by the 
results of practice. It is a mode of seeking indi- 
cations that is warranted by the facts, that provings 
on the healthy — the only absolutely certain source 
of indications for treating the sick — can never 
furnish us analogues of the exudations and infiltra- 
tions referred to by Wurmb. We must in such 
cases fall back on generalizations based jointly on 
pathology and pathogenesy. 

This generalization will give us an explanation 
of the beneficial action of Sulphur in the second 
stage of exudative inflammation throughout the 
body ; as in meningitis, ophthalmia, otitis, perito- 
nitis, haemorrhoidal tumors, pleuritis, pneumonia, 
periostitis, ostitis, adenitis, pericarditis. 

But the generalization does not exhaust the 
subject of the applications of Sulphur. In puerperal 
peritonitis, at the very commencement of the disease, 
Sulphur is, I think, our most efficient remedy. 



SULPHUR. 



I 

391 



Even here there is an analogy to the second 
stage of an idiopathic inflammation. For it may be 
considered that the storm of invasion was exhausted 
by the labor of which the peritonitis is a sort of a 
sequel. And perhaps this view accounts in some 
measure for the asthenic character of this disease 
from the outset. 

The skin diseases for which Sulphur is appro- 
priate are papular, vesicular, or pustular eruptions, 
with the peculiar sensations already described. 

As regards itch — scabies — if we restrict the 
term to the vesicular affections caused by the 
acarus, we must doubt the power of Sulphur to 
cure it specifically. If we use the term as Hahne- 
mann and his contemporaries used it, to embrace 
impetigo, tinea, etc., Sulphur is one of our most 
efficient remedies. 

Sulphur cures an unhealthy state of the skin 
in which it cracks, and in which slight scratches 
ulcerate and are slow to heal. 

The kind of lumbago caused by Sulphur has 
been described. 

In the second stage of acute articular rheuma- 
tism, where deposits are to be removed and where 
the feet in particular are affected, it is of great 
service. 

In certain forms of paraplegia of children it 
often effects a cure. 

Never prescribe this or any other drug without 
carefully comparing the symptoms of the case with 
those of the drug. 



392 



SULPHUR. 



GENERAL VIEWS. 

The limbs go to sleep easily ; sensation of las- 
situde, weariness and soreness in the limbs and 
bone pains, as if the flesh were off the bones. 

Prickling and itching of the skin, at night in 
bed. Old scars and spots begin again to itch ; 
soreness but not burning. 

A scabious, eczematous eruption like cow-pox. 

Jerking spasms of individual limbs and attacks 
like epilepsy, preceded by a feeling in the arms and 
back as if a mouse ran up them. 

Ebullitions of blood, the veins of the hands 
swollen and burning, and from this restlessness 
throughout the body. Cannot sit in one posture ; 
must stretch out the hands, limbs and toes. 

Sleepiness by day ; in the afternoons ; recurring 
after meals. 

Late sleeping in the morning, not refreshed on 
waking. Sleepy in the evening, but cannot go to 
sleep for a long time ; and during the night, 
Wakeful, with excitement and restless tossing, and 
pressure of blood to head and chest. Wakes in 
affright. Lively and anxious dreams. Many symp- 
toms come at night; burning in mouth, with thirst; 
nightmare; pains in hip joint; cramps in calves. 

Fever. Mixed.' Cold predominates. 

Heat. Partial, and in the head and chest. 

Excited, hasty, going from one subject to 
another ; depressed and despondent. 



GRAPHITES. 



HIS remedy belongs exclusively to the Homce- 



-L opathic Pharmacopoeia. It was classed by 
Hahnemann among the " Antipsoric Remedies," as 
being more especially adapted to the treatment of 
chronic diseases. We shall see that it is some- 
times called for in acute affections. 

In his introduction to the proving, Hahnemann 
says : 

" The purest Graphite is a kind of mineral 
carbon. Its slight contingent of iron may be 
regarded rather as an admixture than as an 
essential constituent, as was fully proved by Davy's 
conversion of the diamond into Graphites by treat- 
ing it with Potassium." 

He continues: 

" The first idea of its use in medicine was given 
to Dr. Weinhold, during his travels in Italy, by 
some workmen in a looking-glass factory in Venice, 
whom he saw using Graphites as an external 
application for the removal of eruptions. He imi- 
tated them and described the result in a little 
work, entitled "Graphites as a Remedy for Erup- 
tions. 1812." 




394 



GRAPHITES. 



Hahnemann's proving is published in the 
"Chronic Diseases." 

The action upon the sensorium is not marked. 
Upon the head, confusion and pressure, chiefly in 
the forehead, and a drawing pain from the fore- 
head extending down the face to the throat. So, 
likewise, the pain of constriction extends down the 
occiput to the nape of the neck. The headache is 
often very violent every morning, causing cold 
sweat and faintness. 

Externally, the action of Graphites is note- 
worthy. Scabby eruptions, exuding moisture, ap- 
pear on the scalp ; they are sore when touched, 
and cause the hair to fall out. This furnishes an 
indication for Graphites in tinea capitis. We meet 
here the first example of the skin affection of 
Graphites, — a moist, scabby eruption. Lyoopodium 
has a dry, scaly eruption. Mezereum, a thick, hard 
scab, from under which, when it is pressed, thick 
pus exudes. Hepar sulphuris, a scab easily torn 
off, and which leaves a raw and bleeding surface. 

Viola tricolor in tinea capitis is indicated by the 
peculiar odor of the urine of the patient. It smells 
like cat's urine. 

Face. The complexion is pale and sallow ; the 
eye sunken. The muscles of one side of the face 
are contracted, and speech is difficult. Externally, 
a kind of erysipelas, with a burning, sticking pain. 

In acute facial erysipelas, in which Belladonna 
and Rhus are so often indicated and serviceable, 
Graphites or Euphorbium or Apis may be required. 



GRAPHITES. 



395 



If so, they are particularly indicated by symptoms 
of other organs. So may Carbo animalis. 

Eyes. Paralytic heaviness of the lids. Vision 
is so affected that myopia results. Photophobia, 
heat, biting lachrymation, and pressing, aching 
pain in the globe which extends to the head. 
Also stitching pains in the eye from looking on 
white objects. Ulceration of the margins of the 
lids. Where hordeola recur frequently, although 
each one is relieved by Pulsatilla, Graphites or 
Staphysagria may be indicated by the general 
symptoms, and each has been beneficial in many 
cases. 

Ears. Various noises in the ears, rushing, 
ringing and hissing. These noises and a clucking 
or cracking noise are produced by stooping and 
rising again, by eructation, by eating, and gener- 
ally by moving the jaw. These symptoms point 
(analogous to Silicea, Lachesis and Gelseminum) to 
an affection of the Eustachian tube (and perhaps 
the meatus externus). Graphites has been of ser- 
vice in many cases of deafness. Itching of the 
external ear and of the cheek in front of the ear. 
Where the parts have been scratched lymph 
exudes, and "a raw" is established. 

In a crevice behind the ear a crack, raw, moist 
and quite painful, similar to the cracks in chapped 
hands. 

Similar cracks are observed in this locality in 
children during the age of dentition or after it. 
Graphites is a valuable remedy. So is Calcarea 



396 



GRAPHITES. 



carbonica, which may be indicated in preference by- 
other symptoms. 

Nose. Increased acuteness of the sense of 
smell. Scabs in the anterior nares ; occasional 
epistaxis, with fullness of head and heat of face. 

Mouth. Around the mouth and on the lips 
and chin, eruption and scabby ulcers ; swelling of 
the sub-maxillary glands. The breath is offensive, 
or smells of urine. 

Gums swollen and sore. The toothache is 
worse in bed and from warmth. 

A kind of spasm in the throat, as if deglutition 
were impossible. 

Digestive Tract and Function. The tongue is 
much coated ; the taste is bitter, there is much 
hiccough and eructation of bitter or sour green 
water. 

Aversion to meat and to sweets; much thirst; 
nausea, even when there is strong hunger. Graph- 
ites produces many symptoms after eating, such as 
headache, sleepiness, waterbrash, burning in the 
eyes, colic, fullness in the abdomen. Cutting, 
burning and drawing pains in the abdomen. Espe- 
cially, however, is the abdomen tense, as though 
distended with flatus, which appears to be incarcer- 
ated in various parts of the abdomen. Pressing 
toward the abdominal ring before discharge of 
flatus. These symptoms — the abnormal sensations 
and accessory symptoms after eating, the accumu- 
lations of flatus — indicate slow and imperfect 
digestion, a condition which is demonstrated by 



GRAPHITES. 397 

the stool so characteristic of the Graphites diarrhoea, 
viz., pappy, half-digested brown stool, of a most 
atrocious odor. 

Rectum. In the rectum, violent stitches, a 
smarting or cutting and sore pain ; also much itch- 
ing. The anus is swollen, the veins enlarged, 
protruding and sore. These symptoms have led 
to the successful use of Graphites in that pain- 
ful affection, "fissure of the anus," which can be 
cured by homoeopathic remedies speedily and 
permanently, and needs no surgical intervention. 
Ignatia, Nitric acid, Platina, Plumbum, P^eonia 
alba, and Ratanhia, are other remedies that may 
be required, and have proved successful in "fissure 
of the anus." 

Stool. Two conditions obtain. Constipation, — 
the stools are hard, lumpy, and evacuated with 
effort, and often accompanied with mucus or blood. 
There is sometimes ineffectual tenesmus. On the 
other hand, there is diarrhoea; stools not frequent, 
generally in the forenoon ; pappy, brown, contain- 
ing half-digested food, and of an atrocious, almost 
putrid odor, not attended with pain, but often 
accompanied by discharge of flatus. I cannot say 
which of these series of symptoms is primary and 
which secondary. ' In reference to a recent much- 
pushed theory, I am constrained to say that, as 
regards the dose, it makes no difference which is 
primary and which secondary. With the 200th I 
have cured constipation, and with the 200th I have 
cured diarrhoea. 



398 



GRAPHITES. 



Urine is diminished in quantity. A cutting 
pain accompanies the evacuation. Urine is dark 
and has a white or a reddish deposit. 

Male Sexual Organs. The sexual appetite is 
decidedly increased, but the power is diminished, 
ejaculation of semen taking place before the erec- 
tion is complete. By virtue of this action, Graph- 
ites has been of service in sexual weaknesses, 
consisting of lively desire with incomplete erection, 
and too rapid or too early discharge of semen, 
such as sometimes follows the habit of masturba- 
tion, acquired in boyhood and abandoned early. 

Testes Swollen. It is noteworthy that Graphites 
has been successfully used in treating hydrocele. 
Other remedies are Clematis, Rhododendron, Aurum 
and Spongia. 

The Female Sexual Organs present many symp- 
toms that point to Graphites as a remedy for 
corresponding maladies. 

Menses are delayed and are scanty ; they are 
imminent for several days before the flow fairly 
sets in. The onset is accompanied by a variety 
of accessory symptoms (as with Sepia), such as 
hoarseness with dry cough, headache evenings, 
swelling of the feet and painless swelling of the 
cheeks, chilliness, colic-like labor-pains, backache. 

Hahnemann says that Graphites is often indis- 
pensable where obstinate constipation and delayed 
menstruation are wont to occur together. 

Leucorrhcea copious and thin, causing a biting, 
smarting sensation in the vagina. 



GRAPHITES 



399 



Upon the respiratory organs the action of 
Graphites is not marked. It produces coryza, 
hoarseness toward evening, attended by headache; 
rawness in the chest and a tickling in the throat, 
provoking a dry cough, the peculiarities of which, 
however, are not apparent. There is some 
dyspnoea. 

Externally, the nipples are painful and tender, 
and disposed to become fissured. 

Clinical experience has shown Graphites to be 
a valuable remedy in "sore nipples" of nursing 
women. The end of the nipple presents cracks 
and fissures from which exudes a limpid serum. 
This disposition to fissures or cracks in the integ- 
ument seems characteristic of Graphites. 

In the extremities, besides aching and drawing 
sensations and the indefinite feeling of lassitude, 
common to so many drugs which act profoundly 
on the system, we have no marked action save 
that on the skin, viz., erysipelas of the hands, 
eczema of the fingers, eczema and impetigo on 
the lower extremities and toes. There are stick- 
ing pains in these eruptions and much soreness. 
Eczema between the lower extremities and upon 
the male genitals is an effect of Graphites. 

The feet sweat profusely ; the sweat is not of- 
fensive as under Silicea, but moderate walking 
causes soreness between the t.oes, so that the parts 
become raw. Finally the sides and roots of the 
finger and toe nails become sore, ulcerate and swell 
and are exceedingly painful. 



AOO GRAPHITES. 

Graphites is one of our best remedies in that 
painful affection loosely called " the ingrowing toe- 
nail." Silicea and Hepar sulphuris are also of 
value, and must be chosen in preference if general 
symptoms require it. 

As regards sleep, Graphites produces great 
sleepiness by day; and the patient goes to sleep 
early in the evening, but during the night there is 
wakefulness, tossing, heat and anxiety (symptoms 
much like those of Sulphur). Dreams are anxious 
and terrifying. At last patient sinks into a pro- 
found and dull morning sleep. (This is not like 
Sulphur.) 

Fever has been observed. Coldness predomi- 
nates — a daily paroxysm — in the evening. It 
begins with shivering followed by heat of the face 
and cold feet, followed by sweat in the morning. 

Generally a moderate exertion brings on sweat. 

The disposition is excited and irritable. 

The action on the skin is very marked : moist 
eruption, eczema, impetigo, and fissure or cracks on 
the fingers, at the corners of the mouth, on the 
nipples, at the anus and between the toes. 

Already-existing ulcers become tender to touch 
and motion, with tearing and sticking pains. 

The action of Graphites on the skin, the digest- 
ive apparatus, and the male and female sexual 
organs, is of great importance. It is eminently a 
" polychrest." 



LACHESIS. 



VENOM OF LACHESIS TRIGONOCEPHALY. 

IT was procured by Dr. C. Hering, and proved 
under his auspices. The results were published 
in "Archiv," and in his monograph " Schlangengift." 

The symptoms given by him are both those of 
the bite and those produced by internal use. 
There is an evident correspondence between the 
two varieties of symptoms, the latter presenting 
finer shades of subjective symptoms than could be 
observed under the severe effects of the bite. 

Seiisorium. Absence of mind, inability to think ; 
has to think how words are spelled ; errors in 
writing and reading ; vertigo ; giddiness, especially 
on closing the eyes, on sitting or lying down 
(Theridion) ; vertigo, with staggering ; deadly pale- 
ness (nausea and vomiting sometimes). 

Head. Pains deep seated in various parts of 
the head, worse on the left side. In the left 
frontal protuberance a sore pain, worse early in 
the morning — worse on pressing the parts; sore 
aching above the eyes, extending to the root of 
the nose and down the nose ; heaviness on waking, 
27 



402 



LACHESIS. 



with nausea and vertigo, such as is produced by 
exposure to the heat of the sun ; curative in sun- 
stroke ; pressing pain in the forehead from within 
outward ; bursting, throbbing and undulating pain 
in the forehead, generally worse after sleep and on 
stooping, attended by vertigo and sometimes by 
nausea and by weakness of the limbs and of the 
mind. 

Scalp. Sensitive, especially the left side, as if 
it had been burned by the sun. 

Eyes. Most of the symptoms are subjective, 
and consist of pains aboye the eyes ; aching and 
pressure in the eyes, worse on touch and motion ; 
and itching and stinging in the eyes. 

Given on the strength of these symptoms, and 
others affecting other organs, Lachesis has been 
curative in inflammation of the margins of the 
lids, and in ulceration of the cornea. Vision is 
affected ; it becomes weak — objects are not easily 
discerned ; there is a mist before the eyes, also 
black flickering objects before the eyes, and a 
bright ring around the candle flame. 

Ears. Soreness of the mastoid region ; swell- 
ing between the ear and mastoid process, with 
stiffness, pain and throbbing ; stinging and piercing 
pain deep in the left ear, with a disagreeable sen- 
sation between the ear and throat. The ears feel 
obstructed, and there is deafness ; at the same time 
abnormal sounds are heard in the ears — chirping, 
roaring and the hammering sensation or sound 
which is peculiar to Lachesis. These sounds cease 



LACHESIS. 



403 



for a while after inserting the finger in the external 
meatus and shaking it. They probably depend 
upon obstruction of the Eustachian tube. 

Nose. Epistaxis is a frequent symptom both 
from bites and from internal use. It precedes the 
menses, accompanies the headache, occurring espe- 
cially early in the morning, and is often induced 
by blowing the nose. 

Soreness with discharge of water, and the 
soreness remains long after the coryza has ceased. 
Obstinate coryza, alternately fluent and dry, break- 
ing out suddenly. 

Lachesis has proved a valuable remedy in 
obstinate coryza, in complaints seeming to depend 
on suppressed coryza, and in the sequelae of influ- 
enza ; also in ozcena with suspicion of a syphilitic 
taint. 

Face. Complexion pale, yellow, earthy. Eyes 
sunken. 

Prosopalgia. Tearing above the orbit. Draw- 
ing and tearing in the malar bone,* extending to 
the ear. Digging and screwing around in the 
malar bone. Swelling of the face, closing the eyes, 
worse on the left side. 

Erysipelas of the face, worse under the left eye ; 
swelling of the lip, distortion of the face. 

Teeth and Jaws. Tearing and throbbing, 
especially about the roots of the teeth, worse after 
sleep and by cold or warm drinks, with swelling 
of the gums (ending in discharge of pus). An 
excellent remedy in periodontitis from dead nerve 



\ 



404 LACHESIS. 

pulp in the fang of decayed or plugged molar, 
which must end in abscess. The gums bleed 
easily. 

Mouth. Burning in the mouth and soreness of 
the roof of the mouth. 

Ptyalism. Burning as from pepper. Tongue 
white, yellow, blackish. Tongue stiff, difficult to 
protrude. It trembles when protruded. Paralysis 
of the tongue. 

Tongue swollen ; ulcerated. 

Gangrene of the tongue. Difficult speech, as 
if the tongue were too heavy. Unintelligible talk- 
ing after an apoplectic fit. 

Inflammatory swelling of the velum pendulum 
palati. 

Pharynx and (Esophagus. Feeling of hollow- 
ness in the throat, as if the pharynx had disap- 
peared. (Phytolacca decandra.) Rawness in the 
pharynx. Sensation as of a lump in the pharynx, 
generally on the left side, impeding deglutition, 
worse on deglutition, and a sharp pain then goes 
into the ear. Constant desire to swallow, as if 
a sponge or a button adhered to the left side of 
the pharynx, worse from swallowing food. Lumps 
dark red, with ulcers or gangrenous spots. Fetor 
of breath. 

Difficult deglutition. Abnormal contractions of 
pharyngeal muscles; food returns by the nose. 
As if a piece of dry skin were ' in the pharynx. 

(Tonsillitis beginning on the left side. Lyco- 
podium where it begins on the right side. Lippe.) 



LACHESIS. 



405 



Taste. Bad, bitter, putrid, flat. Loss of appe- 
tite, but faintness from fasting. Empty, faint feel- 
ing in the stomach. 

Weakness of digestion, distress from food, 
especially in drunkards. 

Stomach. Regurgitation of food. Nausea and 
vomiting with vertigo and faintness. 

Tenderness in the epigastrium. Gnawing be- 
fore a meal. 

Pressure toward the heart. All the symptoms 
are worse after sleep. 

Sensation in the stomach and abdomen, as if a 
lump were accumulating. 

Hypochondria. Cannot bear tight clothing 
about hypochondria (characteristic). Pain as if 
ulcerated on coughing. Pain in the liver as 
if forming a lump, as if something had lodged 
there. 

Abdo??ien. Tension. Pain as if diarrhoea would 
set in. Stitches in various directions, as from the 
right os ilium through the abdomen and chest as 
far as the shoulder. Stabbings during the menses, 
soreness and sharp pain in the left ovarian region, 
cannot lie on the left side because it hangs and 
rolls over. Sensitive ; cannot, when standing, bear 
down weight and pressure of clothing; must hold 
it up, it produces pressure on the uterus. 

Painful swelling and induration in the right 
side of the abdomen, between the crista ilii and 
umbilicus; burning, pulsating, etc., and pains 
extending to the hip joints, etc. 



406 



LACHESIS. 



Stool. Constipation. Hard fragments like 
sheep-dung ; difficult evacuations, as from spasm 
of the sphincter; feels as if faeces press against it 
without passing. 

Stools light colored, and alternately loose and 
dry and hard. 

Cadaverous odor of diarrhceic stool. Blood and 

pus. 

Drawing and hammering in the anus. Urging 
as of stool, worse when sitting ; makes lame, can- 
not rise. Prolapsus ani, with bleeding. 

Urinary organs. Micturition frequent. Urine 
scanty and dark, and turbid with dark sediment. 

Male sexual organs. Depressed condition. 

Female. Menses scanty and inclined to delay, 
preceded and attended by many accessory symp- 
toms (nervous attacks). Leucorrhcea befo7 r e menses, 
copious and acrid and thick. Uterus very sensitive 
to contact. Cannot bear external pressure on the 
uterine region nor the weight of clothes. 

At the climacteric period flashes of heat. Pain 
in the uterine region, increasing day by day till a 
bloody discharge appears, then ceasing, to re-appear 
in a few days. 

Larynx and Cough. Pain when touching the 
larynx and on lying down. Throbbing and sensa- 
tion of narrowness. Swelling sensation, rawness, 
scraping and desire to swallow. Sensation as of 
a plug which moves up and down, with short cough. 
Hoarseness, worse in the evening, and with a sen- 
sation as of something which ought to be hawked up. 



LACHESIS. 407 

Cough generally dry, spasmodic, provoked by 
tickling in the throat, by smoke, by pressure on 
the larynx as by touch, throwing the head back, 
etc. ; worse every time he wakes ; worse from eat- 
ing ; has always to leave the table. Sometimes 
mucus and bloody (latter generally when sympa- 
thetic with heart trouble), again thick yellow sputa 
in suspected phthisis pulmonalis. 

Chest. Dyspnoea on exertion, or attending other 
symptoms. In paroxysms, suffocative fullness. 
Cannot lie down ; must have windows open. 
Stitch in the left side, with dyspnoea, worse 
when coughing or on inspiration ; neglected 
pneumonia. 

Spasmodic pain about the heart. Constrictive 
sensation in the region of the heart. Irregular 
beating of the heart ; every intermission attended 
by strange sensation in the heart, and as if the 
circulation were restored by coughing a little. 
Palpitation, with anxiety and weakness ; spasmodic, 
suffocative feeling, with palpitation on exertion. 

Trunk. Pain in the loins. Stiffness from the 
sacrum to the loins, and extending down the 
thighs (with tenderness in the right ileo-ccecal 
region). Drawing pains and stiffness in the back 
and nape. Beating in the back and anus as with 
little hammers. 

Great painfulness of the neck to touch and 
pressure. Outer swelling with inward inflammation 
and soreness. Swelling and pain in the submax- 
illary and parotid region. 



408 



LACHESIS. 



Lameness, tension and numbness in the hands 
and feet. Limbs weak, weary and trembling. 

Ulcers bluish, livid, worse in the evening, sur- 
rounded by smaller ulcers, and burn when touched. 

Sleep. Drowsiness and stupor all the time. 
At night easily disturbed, not refreshed, always 
worse after sleep. 

Fever. Not regular, periodic. Fever of low 
type ; prostrate with stupor ; muttering ; sunken 
face, dropping of the jaw, red or black tongue, 
cracked and bleeding, and which trembles when 
protruded. 

Skin. Ulcers, etc. Gangrene traumatic, of an 
ashy gray color and very offensive. 

General symptoms. Languor, weariness, pains. 
Aching in bones. Awkward, stumbling gait, numb- 
ness of the hands and feet, paralysis, mental and 
bodily languor. Constant desire for rest. Faint- 
ness, trembling. Vertigo. 

Disposition. Depression, melancholy. Anxiety 
about her illness, nervous irritability. Inertness. 

APPLICATIONS. 

Lachesis, in common with other serpent poisons, 
produces, first, direct weakness of the heart's action ; 
second weakened respiration and difficult degluti- 
tion ; third, an incoagulable condition of the blood, 
and third, as Mitchell proved by experiment with 
Crotalus venom, actual disorganization of the mus- 
cular tissue. Locally it produces gangrene. 



LACHESIS. 409 

From this we may have, first, death from syn- 
cope or suffocation ; second, ecchymoses and death 
from blood disorder; third, local gangrene. 

Again, we have special peculiarities of heart 
and throat symptoms, etc., which characterize 
Lachesis. 

The throat action begins, according to Lippe, 
on the left side, and extends to the ear, accom- 
panied by tightness in the larynx. Internally, 
deep red or purple ; externally, swelling as though 
the cellular tissue were infiltrated ; external tender- 
ness, no coating of tongue like mercury ; no 
defined sharp prick like Hepar sulphuris, nor fever, 
etc., like Belladonna, which has bright redness. 

Scarlatina, two applications ; first, in the fou- 
droyant style of invasion ; second, when there is 
infiltration and threatened sloughing of the throat 
and gangrene. 

Typhilitis. Haemorrhoids. Diseases of women. 

Couo^h, etc. 

In neglected pneumonia, or when resolution 
lingers, or after whooping cough. 

Heart affection, weakness of action, palpitation, 
irregular beats, aching, etc., but especially cannot 
lie down, and cough sympathetic. Ulcers. Par- 
alysis. 

[This paper is supplemented by an additional 
one on the same drug in the second volume.] 



LECTURES 



MATERIA MEDICA. 



CARROLL DUNHAM, M. D. 

Al'THOh. OF " HGMCEOPATHY THE SCIENCE CF THERAPEUTICS; " ETC. 



5? * 



PHILADELPHIA: 

F. E. BOERICKE, 

HAHNEMANN PUBLISHING HOUSE. 
1884. 



Entered, according to Act of Congress, In the year 1878, 

By Carroll Dunham, Jr., 
In the Office of the Librarian of Congress, at Washington. 



CONTENTS. 



Page. 

I. Principles of Homceopathy — Prin- ^ 

ciples vs. Practical Knowledge S 1 
II. Symptoms, their Study ; or " How > 



TO TAKE THE CASE " S 

III. The Anamnesis 49 

IV. Pulsatilla 57 

V. Cyclamen Europium 80 

VI. Euphrasia Officinalis 98 

VII. Allium Cepa 105 

VIII. Matricaria Chamomilla 108 

IX. Ignatia Amara 122 

X. Platina 129 

XI. Sepia 138 

XII. Murex Purpurea 158 

XIII. Kreasotum 164 

XIV. Secale Cornutum 169 

XV. JUNIPERUS SABINA 175 

XVI. Achillea Millefolium 177 

XVII. Arsenicum Album 178 

XVIII. Hydrargyrum 208 

XIX. CUCUMIS COLOCYNTHIS 23 I 

XX. Podophyllum Peltatum 239 

XXI. Lachesis 243 

XXII. Lycopodium Clavatum 256 



CONTENTS. 

Page. 

XXIII. Natrum Muriaticum 266 

XXIV. Veratrum Album 272 

XXV. Hepar Sulphuris Calcareum 280 

XXVI. Dulcamara 287 

XXVII. Calcarea Carbonica 307 

XXVIII. Causticum 317 

XXIX. Nitric Acid 320 

XXX. Carbo Vegetabilis 325 

XXXI. Carbo Animalis 332 

XXXII. Apium Virus 333 

XXXIII. Phosphorus 338 

XXXIV. COCCULUS INDICUS 346 

XXXV. Conium Maculatum 362 

XXXVI. Cina 367 

XXXVII. The Art and Mode of Prescribing. .386 

XXXVIII. Pathognomonic Symptoms and ) 

Characteristic Symptoms.... > ^ 2 

XXXIX. Valedictory Address 402 



PRINCIPLES OF HOMCEOPATHY.— PRIN- 
CIPLES vs. PRACTICAL KNOWLEDGE. 



IN entering upon the general consideration of any 
subject involving a number of topics, it is 
expedient always to seek to obtain at the very 
outset a clear view of the scope and extent of the 
subject ; to comprehend what it involves and to 
perceive what are its limits and what its relations 
with other kindred subjects. Let us begin our 
course by doing this with reference to homoeop- 
athy, the principles of which it is my duty to lay 
before you. 

You all know that by homoeopathy is generally 
understood that system of practical medicine, in 
accordance with which the physician seeks to cure 
his patient by giving him a remedy which has been 
known to produce in the healthy subject symptoms 
similar to those which the patient presents. It is 
a system claiming to be the only scientific system 
of medicine, inasmuch as it possesses a "law ol 
cure" as it is termed; or, as it might be more 
correctly expressed, a law for the selection of the 
remedy in any concrete case of illness; the law 

II.— 2 



2 



PRINCIPLES OF HOMOEOPATHY. 



expressed by the now familiar formula — " Similia 
s im il ibus cu ra n tur" 

You will hear also that homoeopathy is called 
the science of therapeutics, and I will add that it 
is the only therapeusis which exists possessing the 
elements of a natural science; that it is the only 
science of therapeutics. Now, by therapeusis or 
therapeutics, we mean the science of treating dis- 
eased persons by means of drugs. 

We thus arrive at a view of the limits and 
scope of our subject, homoeopathy. It is a thera- 
peutics. It deals with the science and method of 
treating the sick by means of drugs. And this is 
its whole scope. As homceopathists strictly, and 
confining yourselves to the application of the sci- 
ence of homoeopathy, you will perform your entire 
function when you accurately select and rightly 
administer a suitable drug to your patient. 

But you will go forth from these halls as 
doctors of medicine. Shall you have no other 
professional duties toward your patients than to 
administer drugs to them? Assuredly you will. 
Then you must be homceopathists and something 
beside. 

The injuries and accidents to which men are 
exposed, involving destructive injury to limb or 
tissues, may require the interference of the opera- 
tive surgeon. As such you will act under the law 
of mechanics, guided by your knowledge of anat- 
omy and physiology, and governed by the traditions 
and maxims of surgery. It is true that few surgi- 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 



cal cases occur which do not sooner or later 
involve the entire organism in such a way that 
the patient's condition demands the co-operation of 
the therapeutist; and as you will combine in your 
own person the function of operative surgeon and 
therapeutist, you, who have when operating, acted 
outside of your office as homceopathist or thera- 
peutist, will now select and administer a drug 
suited to the condition of your patient, in accord- 
ance with the therapeutic law. You will, thus, in 
treating this case, act in a double capacity. You 
will be both an operative surgeon and a prescriber 
of drugs. It is in the latter capacity only that 
you will be a therapeutist, that you will practice 
homoeopathy. It is true that your possession of a 
science of therapeutics will make the intervention 
of operative surgery much less frequently necessary 
than it is deemed to be by our allopathic brethren, 
who have no science of therapeutics. For homoeop- 
athy gives us the means of curing many diseases 
formerly supposed to require mechanical treatment; 
and in so far your function as homceopathist will 
encroach on that of surgeon. Yet the two are in 
a scientific aspect entirely distinct, and may not be 
confounded, unless you would introduce confusion 
into your views of the principles of medicine. 

So, likewise, as obstetrician, you are called upon 
to superintend the physiological process of partu- 
rition, to prevent accidents or to remedy them ; to 
anticipate or to cure diseases that may complicate 
the process. Some of your interference will be 



4 



PRLXCIPLES OF HOMOEOPATHY. 



mechanical, as when you turn the child or use 
instruments. Such interference does not come under 
the scope of homoeopathy. It belongs to another 
department of science and art. Another kind of 
treatment for the abnormal conditions which may 
supervene during parturition, consists in the admin- 
istration of drugs in accordance with the homoeo- 
pathic law. In doing this you are acting of course 
within the limits of the science of homoeopathy, 
being therapeutists. Thus in the practice of obstet- 
rics you fill a double office ; you are therapeutists, 
and as such, homceopathists, and may also be oper- 
ative surgeons, exercising another art. 

Here again homoeopathy puts us in possession 
of remedial means which, in a great many cases, 
obviate the necessity of resorting to mechanical 
interference, because they enable us to prevent the 
occurrence of morbid states which lead to conditions 
requiring such interference ; and thus the function 
of the homoeopathic therapeutist circumscribes that 
of the operative obstetrician, as it is laid down in 
the text-books of the allopathists. And it should 
be our aim so to develop our therapeutic science 
as still further to circumscribe its limit and do away 
with the necessity for operative interference. For 
instance, if. I may venture to spend a moment on 
this subject, homoeopathy, as a system of thera- 
peutics, educating our powers of observation and 
sharpening our clinical foresight, enables us to antic- 
ipate the recurrence of uterine haemorrhage as an 
incident of parturition, and so to prescribe that 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 



we prevent or control it; thus making the mechan- 
ical appliances so frequently resorted to by the 
allopathists at least so seldom requisite that some 
homceopathists have affirmed that the tampon, etc., 
can never be required. In the same way and to 
the same extent of rarest use or absolute disuse 
has homoeopathy brought the entire apparatus of 
pessaries and supporters and bandages for the 
treatment of uterine disease. In these cases, as 
in other similar cases, it will be for you, in the 
exercise of a sound judgment, to determine whether 
the best interests of your patient demand that you 
shall act solely as operative surgeon, or solely as 
therapeutist, or whether you shall combine these 
functions. You cannot exercise this sound discre- 
tion aright unless you are fully instructed in both 
departments of science, unless you know all that can 
be effected by therapeutics from the stand-point of 
the homceopathist, and know also the resources and 
limits of operative surgery. The point which I 
wish to make is that as doctors of medicine you 
combine in yourselves the functions of therapeutist, 
surgeon and obstetrician ; and that in the latter 
capacity you do not, cannot, and are not called 
upon to act as homceopathists, inasmuch as the 
homoeopathic law applies only to the selection of 
drugs for diseased conditions. 

Once more, hygiene is that department of 
medical science which includes the prevention of 
disease, and the removal or cancellation of material 
causes which induce or perpetuate disease. The 



6 



PRINCIPLES OF HOMOEOPATHY. 



advances of physiology and pathology, chemistry 
and natural history, within the last thirty years, 
have given to sanitary science a scope and impor- 
tance which were not heretofore imagined. Many 
epidemic diseases have been shown to be depend- 
ent upon the conditions in which the individual, 
the family and the community live — conditions 
which by knowledge and care might be obviated. 
I refer in general to improper drainage of the soil, 
deficient ventilation, unwholesome food and drink, 
lack of light and heat, injurious occupations, 
improper social habits and relations. Surely the 
doctor of medicine can have no more important 
business than the prevention of disease by diligent 
endeavor, — whether as a public officer or as the 
medical adviser of a family or of an individual, — 
to modify unfavorable conditions, and thereby 
remove material causes of disease, and place those 
with whose care he is charged under circumstances 
most favorable to health. In doing this you will 
apply the principles of chemistry or of mechanics or 
of vegetable physiology; and although fulfilling one 
of your most important vocations, you, who will 
style yourselves homoeopathic physicians, will not be 
acting within the scope of homoeopathy ; will not 
be applying its law of cure. You will, as hygien- 
ists, have nothing to do with homoeopathy. 

Furthermore, it has been ascertained by modern 
research, that certain diseases depend for their 
perpetuation, if not wholly for their origin, upon 
parasitic vegetable or animal growths, the removal 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 



7 



of which by chemical or mechanical means is an 
essential condition of speedy cure. While you 
effect this removal by such means, you are fulfill- 
ing your duty as those intrusted with the care of 
the sick, just as faithfully and fully as when you 
administer, in accordance with the homoeopathic law, 
the remedy which shall so change the vital processes 
of the patient as that his body shall no longer be 
a favorable nidus for these parasitic germs. But 
remember that when you seek the aid of chemistry 
or of mechanics to remove these parasites, you are 
not exercising your vocation as homceopathists, 
because you are acting as hygienists, not as thera- 
peutists ; you are not combating disease by drugs. 

I lay stress upon these instances. I desire to 
show clearly, and impress upon your minds the 
fact, that homoeopathy applies only to the treat- 
ment of the sick by means of drugs ; because, 
unless your minds are clear upon this point, unless 
you perceive plainly that as curators of the sick 
you have other functions beside that very important 
and essential one of administering drugs, you may 
err as many do who strive to apply the homoeo- 
pathic law of cure to their every action as medical 
men ; and to make it cover not only their treat- 
ment by drugs, but also the surgical, obstetrical, 
hygienic, chemical and mechanical expedients and 
procedures. They come into the dilemma, that 
either dreading to prove recreant to their guiding 
principle, which they cannot perceive to lead them 
in any of these procedures, they neglect something 



8 



PRINCIPLES OF IIOMCEOPATHY. 



which is essential to their patient's safety or recov- 
ery, and thus fail of their duty as doctors ; or else, 
resorting to measures which their common sense 
and experience show to be necessary, they attempt 
to explain them in such a way as to bring them 
under the homoeopathic law, and thus make them- 
selves ridiculous and bring ridicule upon the science 
which as therapeutists they profess and honor. 

Remember, then, the scope and limits of homoe- 
opathy. It is the science of therapeutics, and con- 
cerns only the treatment of the sick by means of 
drugs. Do not misunderstand me, and think me 
to say, inasmuch as I am a homceopathist, that 
therefore I believe diseases are to be treated only 
by drugs. Being a science, the elements of which 
are natural phenomena, viz. : those of the sick and 
the phenomena of drugs in their relation to the 
living human being, homoeopathy takes rank with 
the other natural physical sciences. 

For the better understanding of our subject 
let us take a general view of the nature and 
elements of a physical science. The physical 
sciences are variously arranged. There are sciences 
of classification, and sciences which are pursued 
with a view to the practical application of the 
knowledge they afford us to the affairs of daily 
life. But all of them deal with the phenomena of 
the physical universe as we observe them by 
means of our senses, aided by the resources of 
art. Let us study for a moment the science of 
astronomy, the most perfect and least compli- 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 



cated of the physical sciences. It deals with the 
phenomena of the bodies which compose the uni- 
verse. We observe these phenomena, which consist 
of the movements of the heavenly bodies in space 
and upon their axes ; and our observation is assisted 
by whatever instruments the ingenuity of man has 
contrived for the purpose, every successive inven- 
tion enabling us to discover some new feature of 
these phenomena. In observations of the move- 
ments of the heavenly bodies we observe their 
movements in relation to each other. This is 
obvious, since the motion of one body is percepti- 
ble only in relation to some other body. Our 
object is to understand the relations of the heavenly 
bodies to each other in respect of their phenomena, 
and then to be able to foresee and predict what 
will be their relations and relative positions at 
some future time. We accomplish this object when, 
by virtue of our studies of the phenomena of the 
heavenly bodies and their relations, we are able 
to foretell the occurrence of eclipses at definite 
times, and to indicate, years beforehand, the posi- 
tion of the heavenly bodies at a given time. 

I ask you now to notice several facts respect- 
ing this science. 

First: In all its processes we never think of 
bringing in the question — What is the cause of the 
motion of the heavenly bodies ? Such a question 
must present itself of course to every reflecting 
mind; but its consideration belongs to the specu- 
lative or metaphysical sciences, and has nothing 



IO 



PRINCIPLES OF HOMOEOPATHY. 



to do with astronomy proper, or celestial mechanics, 
— is certainly in no sense and to no degree a basis 
of it. Our opinions on this point may be most 
various ; yet this variety will not prevent our 
perfect agreement in the processes and conclusions 
of astronomy when considering the relations of, say- 
two heavenly bodies. 

Second: Astronomy deals with two series of 
phenomena, viz. : those of the two heavenly bodies, 
or systems of bodies, under consideration. And 
this science reckons the effects of one body or 
system of bodies upon the other in accordance 
with some law or formula which is general, apply- 
ing to all bodies, and which expresses the mechan- 
ical action of bodies upon each other as regards 
mass and distance ; in other words, their mechanical 
relations to each other. 

Third: This law or formula, expressing the 
relation of bodies to each other, was perceived in 
a single instance. The mind which perceived it 
formed at once the hypothesis that it was a gen- 
eral formula expressive of the relation which exists 
between all bodies. A vast number of experiments 
and observations having confirmed this hypothesis, 
it is now universally accepted as the law of the 
mechanical relations of bodies. 

Fourth: Observe that this law, which is a bare 
statement that bodies attract each other directly as 
their mass, and inversely as the square of their 
distances, is not based upon any theory of the 
nature of attraction — how it is that one body 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. II 

attracts another. Myriads of hypotheses on this 
subject might be framed, defended and overthrown, 
yet this formula would remain unshaken. It 
expresses the relations of phenomena which we 
observe, and nothing more — the relations therefore 
of what we know. For, what besides phenomena 
can we know — phenomena or things which are 
apparent to our senses, which may be seen and 
touched, smelt and tasted and heard. How dis- 
astrous would it be if in our science of astronomy 
the phenomena were limited by a law or formula 
based upon a theory of the cause of attraction. 
Phenomena we see and apprehend, and may be 
said to know, but the causes of them no man has 
seen or touched. Causes are hidden from our 
senses. We can reach them only by the action of 
the mind in hypothetic speculation. It must needs 
be that with every advance in observation a new 
hypothesis would spring up, overturning former 
doctrines of causation, and with them whatever 
laws or formula; might be based upon them; and 
if the central formula of the science rested on 
them, it would be overturned to give place for a 
brief interval to some as short-lived successor. 
Progressive knowledge would be impossible on 
such a basis. 

Fifth : Observe, finally, that one great object 
of the cultivation of this science is, that it affords 
us the means of prevision ; it enables us to foretell 
events within its domain. And this is true of all 
the natural sciences when constructed on a sound 



12 PRINCIPLES OF HOMOEOPATHY. 

basis. It would, therefore, furnish a test of the 
soundness of a science so called. For, on ultimate 
analysis, every natural science (save those of clas- 
sification) consists of two series of phenomena con- 
nected by a law expressive of their relation to each 
other. Now, in the application of the science to 
the purpose of prevision the problem is this : 
Given one series of phenomena and the law of 
relation to find the other series of phenomena, to 
foretell what they will be. This problem is con- 
tinually applied in astronomy, and the results uni- 
formly attest the accuracy cf the method. 

In conclusion, then, this episode enables us to 
state understandingly the elements of a natural 
science. They consist of two series cf phenomena 
(the result of observation), and a law which 
expresses a uniform and invariable relation between 
these series of phenomena. The phenomena must 
be susceptible of indefinite exploration, study and 
elaboration without disturbing the law of relation. 

The law must be such as will enable us to 
foresee and predict future events. One series of 
phenomena and the law being given, we must be 
able to indicate the other series of phenomena ; 
and this in advance of any observation of them or 
of any experiment. 

Such must be the structure and the elements of 
the science of therapeutics, the only possible science 
the elements of which are capable of being devel- 
oped independently by study and experiment and 
observation without detriment to the science as a 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 1 3 



whole, and which in its integrity will enable us to 
foretell the future, will put it in our power, having 
one series of phenomena and the law, to predict 
the other series. 

Therapeutics being the science of treating the 
sick with drugs, it must deal with two series of 
phenomena, viz. : those of the sick and those of the 
drug as it affects the living human body ; and it 
must present us with a law expressive of some 
constant and general relation between the phenom- 
ena of the sick and the phenomena of the drug 
as it acts on- the human body. And by means of 
this law we must be able to foretell events. If we 
have the phenomena of the sick and the law, we 
must be able to tell correctly what shall be the 
phenomena of the drug which will cure the patient, 
even though no such experience has ever been had. 
Or, conversely, having the phenomena of the drug 
as it acts on the human body and the law, we 
must be able to tell what phenomena of disease 
that drug will remove, even though none such have 
ever been witnessed or experimented with. Now, 
gentlemen, homoeopathy is just such a science of 
therapeutics. It has again and again submitted to 
this test, and has come forth triumphant. It pos- 
sesses this law, which is not interfered with by the 
indefinite expansion of the phenomena with which 
it deals. I proceed to state it in detail in the 
light of what has been said. 

The object of your study as medical practition- 
ers is of course the patient — the sick person who 



14 



PRINCIPLES OF HOMCEOPATHY. 



sends for you. Your first care is to ascertain if 
he be really sick. He states perhaps that some 
organ is the seat of pain, that some function is 
not properly performed, or that the unusual appear- 
ance of some part of his body has attracted his 
attention and excited his alarm ; and now he asks 
your opinion, advice and assistance. He wishes 
to know what ails him, what will be the issue of 
his sickness, and how long it will last, and finally 
he wishes you to assuage his sufferings and restore 
him to health as quickly, safely and gently as you 
can. The first question is this, Is the patient sick ? 
Is any organ or tissue in an unnatural condition ? 
Is any function arrested, or performed in an unnat- 
ural manner? You compare the patient with your 
recollection of a sound and healthy man. Your 
knowledge of anatomy will enable you in this 
comparison to detect abnormal conditions of organs 
or tissues. Your knowledge of physiology puts it 
in your power to discern the abnormal performance 
of functions. In a word, you observe whatever of 
a material character is wrong with your patient. 
Where it is possible you assist your senses by 
instruments. The functions of respiration and cir- 
culation are inspected by means of the stethoscope ; 
the tissues of the eye by means of the ophthal- 
moscope ; of the ear by the otoscope ; the tissues 
and, to some extent, the functions of the larynx, 
by the laryngoscope ; the renewal and waste of 
tissue, to some extent, by the thermometer; to 
some extent, by chemical examination, the excre- 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 1 5 



tions and secretions. These examinations, which 
are made by the aid of a comparison of the patient 
with our recollection of a standard, healthy, living 
human being, furnish us with the objective phe- 
nomena which the patient presents. Besides these 
there is another class of phenomena. Rarely are 
any tissues or functions in an abnormal state 
without the existence of some sensations in various 
parts of the body complained of by the patient, 
unless he be in such a benumbed condition that 
he cannot feel nor describe. Such phenomena, 
since they are perceived only by the patient, are 
called subjective phenomena ; we cannot verify 
them. The patient may deceive us in stating them. 
He may not be capable of describing them so that 
we can understand him or get a distinct idea of 
what he feels, or, he may be dull or comatose 
and take no note of them. These objective 
and subjective phenomena together constitute that 
in which the patient differs from a healthy man. 
He wants to know what ails him, for the purpose 
of forming - an idea whether and how soon he can 
get well. You form your diagnosis by means of 
your knowledge of the relation of phenomena to 
lesions of tissue ; and you give your prognosis 
from your knowledge of the history of the course 
of diseases under treatment. You have not come 
to your duties as therapeutists until your diagnosis 
and prognosis have been made and pronounced. 

This having been done, your great duty as 
curers of the sick lies before you. Is the case 



i6 



PRINCIPLES OF HOMOEOPATHY. 



one in which it will suffice to order a change in 
the mode of life, abstinence from some hurtful 
article of food or drink, change from a noxious 
habitation to a more wholesome one, substitution 
of suitable for injudicious raiment, of a nutritious 
for a scanty diet, of a healthy for a baneful occupa- 
tion ? If so, you will have done your whole duty 
when, from the stand-point of hygiene or sanitary 
science, you have cared for these things, and have 
placed the patient under the conditions which are 
requisite for the normal performance of the functions 
of the body and mind. But we will assume that, these 
things having been attended to, the patient remains 
ill ; and that we need to apply to his organism some 
special stimulus which shall bring him back to a 
healthy condition. A drug is such a stimulus. 

We are now in a position to apply the science 
of therapeutics. The phenomena of the patient 
with which we deal, are the subjective and object- 
ive phenomena of which we have already spoken. 
We include these under the general term "symp- 
toms," and we consider that, practically, the aggre- 
gate of the symptoms constitutes the disease under 
which the patient labors. A great outcry has been 
raised against homceopathists because of their 
alleged exclusive attention to symptoms. It is 
affirmed that they prescribe on symptoms only, not 
taking cognizance of the disease, and this is made 
a reproach to them. 

In part this reproach springs from the failure 
to start on a mutual understandine of the term 



/ 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. I J 

symptom. The old school does not give it so 
extensive an application as we do. For we include 
among the symptoms of the patient every devia- 
tion from a healthy condition of mind or body 
which the physician can in any way discover or 
perceive, or which the patient makes known by his 
statement or complaints, or which the attendants 
of the patient have observed and can communicate 
to the physician. Now, this definition includes 
every possible deviation from a healthy condition 
of tissue or function whether objective or subjective, 
which it is possible to have. And what is called 
a disease in contradistinction to such an aggregate 
of symptoms, is simply an abstraction, a mental 
conception devised for the purpose of expressing 
this aggregate in a single phrase. For example, 
the patient has heat of skin, a hard, frequent pulse, 
rapid and short respiration, a quick, dry cough or 
cough with rusty sputa. These are objective symp- 
toms which the physician may observe. The 
patient in addition complains of oppression of the 
chest, of sharp pains through the lung on cough- 
ing, or of rawness behind the sternum. The 
physician, by physical exploration of the chest, 
discovers, on percussing a certain part of the chest, 
dullness, or a fine crepitation. Let this collection 
of symptoms constitute all there is about this 
patient which is a deviation from his condition 
when in health. These phenomena, being the 
results of positive observation, are known ; there 
can be no error or uncertainty about them. Now, 
II.— 3 



i8 



PRINCIPLES OF HOMCEOPATHV. 



if we wish to express to another physician the 
condition of our patient, it may be and is conven- 
ient to have a brief term which will include and 
imply the presence of these phenomena. But does 
it add anything- to our knowledge if we designate 
this aggregate of symptoms by the name pneu- 
monia or inflammation of the lungs ? The fallacy 
is that we are in danger of including under the 
given name cases agreeing in anatomical lesion, 
but differing in symptoms, and requiring different 
treatment. 

It has been objected to the use of a collection 
of symptoms as the basis of a prescription, that, 
if we depend on' symptoms alone, we may fail to 
discover the existence of latent disease. But if 
disease be really latent, not manifested by any 
symptom whatever, by any deviation from a healthy 
condition, why then it must be so completely 
latent, must lie so hidden, that in no way is it 
discoverable. 

Let us remember that Hahnemann taught, and 
that we believe and teach, that the aggregate of 
symptoms, which we regard as identical with the 
disease itself, includes and comprises everything 
which the physician and attendants discover or 
have observed about the patient as different from 
his condition in health, and every deviation from 
health of which the patient is conscious. Let the 
physician avail himself of all the appliances of 
the modern accessory medical sciences, the most 
approved methods of research and observation ; 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 1 9 

whatever he observes in any way in the patient 
which is a deviation from health, is a symp- 
tom in the sense of the homceopathist, and the 
aggregate of these symptoms constitutes for him 
the disease. I may say that the most recent and 
most enlightened writers of the old school, Virchow, 
Carpenter, Bouchut, express themselves much in 
the same sense. 

These symptoms, then, these phenomena of the 
patient, constitute one series of the phenomena 
with which the science of therapeutics deals. 

The other series of phenomena are those of the 
action of drugs upon the • living body. Let us 
come to an understanding of what we mean by a 
drug. The condition of a sick person is this : The 
organs which, while the patient was in health, 
have been performing tlieir functions regularly and 
normally, under the action of the general stimuli 
of light, heat, aliment, etc., on which we all 
depend, have in some way, through some cause, 
come to act abnormally. Now we seek for some 
special stimulus which is capable of modifying the 
action of the organism ; and if we can hit upon 
that stimulus which will modify them in just the 
right way and to the right extent, we shall have 
the means of modifying the organism back from 
its perverted action to a healthy action. To hit 
upon this special stimulus, this is the therapeutic 
problem. 

We gather from this statement that any sub- 
stance whatever which has the power to produce 



20 



PRINCIPLES OF HOMOEOPATHY. 



in the living organism a definite deviation from its 
healthy, normal action, may come under the desig- 
nation of a drug. Thus almost every substance in 
the world, provided it have the power, as most 
substances have, of producing a definite and 
constant modification of function and tissue in the 
organism, may be a drug, and may be used to 
cure disease if we only know how to use it. 
Those who deny the possibility of curing disease 
affirm that a pathological process once begun 
cannot be arrested; — why not as well as a physio- 
logical process ? As a matter of course, almost as 
early as ' men began to record observations of 
nature, in however rude a way, they began to 
note the effects produced upon the organism by 
natural objects taken into the system accidentally 
or by design. And these observations were the 
foundation of the science of pharmacodynamics, or 
the effects of drugs upon the living organism. 
Subsequently systematic observations and experi- 
ments began to be made, with a view of extending 
our knowledge of pharmacodynamics and making 
it exact. It was not however until a very recent 
period that these experiments were instituted on 
the proper basis and in the proper way to secure 
permanent and valuable results. 

At first, and indeed until a very recent date, 
experiments and observations with drugs upon the 
human organism, were made in the case of sick 
persons in the way of endeavors to cure them. 
Now in this way we could not arrive at any 



PRINCIPLES VS. 



PRACTICAL KNOWLEDGE. 



2 I 



certain knowledge of the action of the drug upon 
the organism, because of the organism being 
already in abnormal action under the influence of 
the cause of disease, whatever it might be. 

When we add the modifying influence of the 
drug, the result would be a kind of action due to 
the combined influence of drug and morbific cause. 
Nor could we know how much or what deviation 
to ascribe to each of these influences. Such an 
experiment could give us knowledge of nothing 
save the action of the drug upon an organism 
already affected by disease, precisely as the subject 
of the experiment is affected. But when we con- 
sider how very rarely two identically diseased 
conditions occur, it will be very apparent that such 
knowledge would be of but little practical value to 
us. It would not afford us the constant quantities 
we seek. It was apparent to some of the most 
clear-headed of the earlier physicians, after the 
restoration of learning, that in no way could a 
knowledge of the properties of drugs in relation to 
the human organism be obtained except by obser- 
vations of their action upon the healthy subject. 
Although this conviction was expressed with more 
or less clearness by several, and notably by Haller, 
it was reserved for Hahnemann both to demon- 
strate its truth, and to illustrate it by undertaking 
and accomplishing a gigantic series of experiments 
with drugs upon the healthy organism ; experi- 
ments of which the results constitute the bulk of 
our materia medica; and which form the most 



22 



PRINCIPLES OF HOMOEOPATHY. 



splendid and enduring monument of scientific acu- 
men and philanthropic devotion of which humani- 
tarian science can boast. 

The remarks which were made in relation to 
symptoms as compared with abstract conceptions 
supposed to be represented by them, apply to 
observations of the action of drugs ; since the 
effects of drugs are really artificial diseases. The 
phenomena observed by the prover or his friends 
upon him, whether subjective or objective, consti- 
tute facts ; constitute what we know about the 
action of the drug. Speculations about its mode 
of producing these symptoms are certainly interest- 
ing, and may lead to further discoveries, and 
certainly do stimulate to closer observation ; but 
they are no part of the positive facts which consti- 
tute this second series of phenomena of our science 
of therapeutics. 

We have now two series of facts or phenom- 
ena ; the symptoms of the patient and the symp- 
toms produced by drugs upon the healthy. It is 
reasonable to believe that if we knew how to 
bring the latter action to bear upon the former we 
might arrest the morbid action of the organism ; 
might modify it back to a healthy action, if, among 
all the drugs which act with such a variety of 
difference upon the organism, we only knew how 
to select the right one. 

Wanted, then, a law of selection ; a rule for 
selecting the right drug for each patient ; a formula 
expressing the relation between the symptoms of 



PRINCIPLES VS. PRACTICAL KNOWLEDGE. 



23 



the patient and the symptoms of the drug which 
would cure that patient, the law of the interfer- 
ence of symptoms. 

This law, of which others had had vague glimpses, 
was discovered by Hahnemann to be the general 
law of therapeutics. It was expressed by the phrase 
" Similia similibus curantur /" or " Likes are to be 
treated by likes." It is the law for the selection 
of the drug. It expresses nothing concerning the 
modus operandi of the cure. It ventures nothing 
of hypothesis. It is as bare and as general a 
formula as that of celestial mechanics. 

Discovered by accident, supported by multitudes 
of instances, established by direct experimentation 
and clinical demonstration, it interferes in no way 
with the growth of either series of phenomena, — 
either the phenomena or symptoms of disease, their 
causation and connection, or the phenomena of drug 
action ; and yet it affords us the means of prevision 
that have already been most fruitful of blessings to 
mankind, as in the case of cholera in 1831. 

Let us for a moment, in conclusion, suppose 
the science of therapeutics otherwise constructed, 
first on the rationalistic, and then on the empirical 
basis. 

On the former, the symptoms are observed and 
a cause is assumed for their existence. The action 
of a drug is observed and a theory formed of the 
cause of its action. Here two theories come in to 
introduce two possible points of error. The science 
cannot progress, because advancing knowledge must 



24 



PRINCIPLES 



OF 



HOMCEOPATHY. 



continually change the hypotheses concerning the 
cause of symptoms and of drug effects upon which 
the treatment was based. Take for example the 
use of mercury in liver diseases. It was assumed 
from observation in disease that mercury increases 
the formation and discharge of bile. In certain 
diseases then, which were supposed to depend upon 
a diminished secretion of bile, mercury was admin- 
istered. But subsequent experiments showed that 
mercury does not increase the flow of bile. Then 
all observations and conclusions based on this treat- 
ment must be thrown away as worthless, and we 
must begin again ; and so on ad infinitum. 

The empirical method simply records that A. 
has cured a patient sick with B., and concludes 
that A. is a remedy for B. But diseases occur 
alike so very rarely that the results of treatment 
based on such experience never agree. Nor does 
this method afford means of prevision, a defect 
which is fatal to its claims as a science. Nothing 
remains but the science as we have explained it, 
and of which we shall proceed to study in detail 
and in a practical way the different elements. 

The subject of the next lecture will be : " Symp- 
toms; or, How to take the Case." 



SYMPTOMS, THEIR STUDY; OR, -HOW 
TO TAKE THE CASE." 



IN my last lecture I endeavored to define the 
scope, nature and limits of the science of 
therapeutics, and to show that homoeopathy consti- 
tutes this science. I tried to explain to you how 
it is that, by analysis, every natural science may 
be reduced to two series of phenomena, connected 
by a law or formula which expresses the relation 
of these two series of phenomena to each other ; 
and how the practical problem which the science 
enables us to solve is this : Given one series of 
phenomena and the law of relation, to find the 
other series of phenomena ; and that, in this prob- 
lem lies a test of the soundness of whatever claims 
to be a natural science, viz. : that it furnishes us a 
means of prevision or foreseeing and predicting 
that which is to be observed or discovered ; points 
which I illustrated by a reference to the history 
and structure of the simplest and most complete of 
the natural sciences, astronomy or celestial mechan- 
ics. Finally, I explained that the two series of 
phenomena which are the subject of a natural 



26 SYMPTOMS, THEIR STUDY; 

science, must be each capable of independent and 
indefinite expansion and development as a separate 
department of natural history ; and that no expan- 
sion of either must destroy the applicability of the 
law of relation. I then showed you that in the 
science of therapeutics or homoeopathy (as it is 
more familiarly called) the two series of phenomena 
are respectively the phenomena of the patient on 
the one hand, and the phenomena produced by the 
drug upon the healthy, living, human being, on the 
other hand ; while the formula which expresses the 
relation between these series of phenomena is the 
well-known therapeutic law, " Similia similibus 
curantur" " Likes are to be treated by likes." 

I showed you that, in our practical application 
of the science of therapeutics, the constant problem 
before us is that which is the problem in every 
natural science, viz. : Given one series of phenom- 
ena and the law, to state the other series. Given 
the phenomena of the patient and the law, to find 
the phenomena of the drug which bear to the 
phenomena of the patient the relation expressed by 
the law. Or if we are studying a drug, and have 
the phenomena which it produces in the healthy, 
living, human being, then, having the law, to find 
the series of phenomena in the sick which, bearing 
a certain relation to the phenomena of the drug, 
will be canceled by the latter in the terms of the 
law. In other words, our constant problem is: Given 
the symptoms of a case, what drug known to us 
will cure according to the law, or what must be the 



OR, "HOW TO TAKE THE CASE." 



27 



effects of such a drug, not yet known to us, as will 
cure such a case. Or, conversely : Given the effects 
of a drug, what case, as yet seen or never yet met 
with, will that drug cure ? 

Such prevision as this homoeopathy has again 
and ao-ain in notable cases enabled us to exercise ; 
and by this test she has justified her claim to be 
entitled the science of therapeutics. 

After this general view and analysis of the 
subject, it remains for us to study in detail the 
elements of which the science is composed, viz. : the 
two series of phenomena respectively and the law. 

I shall therefore ask your attention now to the 
first series of phenomena, those of the patient; or 
briefly to the subject of "symptoms," or how to 
take the case. 

And, here, at the very beginning of the sub- 
ject, let me say that much unnecessary confusion 
exists in the minds of our own school, and of our 
opponents, because we have not agreed upon the 
meaning we shall attach to the word symptom. 

By the old school and by some homceopathists 
who have gone astray after the "strange gods" of 
the physiological school of medicine, a very restricted 
meaning is given to the word symptom ; and this 
being done it is made a reproach to homceopathists 
that they take note only of symptoms, as though 
we disregarded some important phenomena pre- 
sented by the patient. Assuming that homceopathists 
understand by symptoms only the subjective phe- 
nomena or sensations which the patient experiences 



28 



SYMPTOMS, THEIR STUDY ; 



and describes, "How, then," exclaims Prof. Bock, 
"can they prescribe for a typhoid patient who 
neither hears, sees, tastes, smells nor feels, and 
who could not express his sensations if he were 
conscious of them, but lies in a passive apathy, as 
indifferent as a log ! " Well, the fact that he lies 
there and cannot express his sensations, if he have 
any, and that the avenues of communication between 
his brain and the world about him, his special 
senses and the general sense namely, are closed, 
constitutes a most important series of symptoms. 
For, gentlemen, in accordance with Hahnemann's 
instructions, no less than with the common sense 
of the matter, we include under the term "symp- 
tom " every phenomenon presented by the patient 
which is a deviation from, or an addition to, his 
condition when in average health. 

Whatever we can ourselves observe by careful 
scrutiny of the patient, bringing to our aid every 
instrument of observation which the ingenuity of 
man has contrived ; whatever the patient can tell 
us as the result of his observation of himself or of 
his sensations ; whatever his friends and attendants 
have noticed concerning his appearance, actions, 
speech and condition, physical or mental, which 
differs from his condition and actions when in 
health, — all these phenomena together constitute 
what we call the symptoms of the patient. 

I conceive that it would be a waste of time to 
examine the alleged distinction between symptoms 
and "the disease." Since we have made the term 



*0R, " HOW TO TAKE THE CASE." 



2 9 



symptom cover every phenomenon, whether it be 
felt by the patient, or observed, seen, handled or 
heard by the physician, it is manifest that we can 
know nothing of any disease except by the presence 
of symptoms ; that its presence is announced by the 
manifestation of symptoms ; that when the symptoms 
have all disappeared we cannot know that any 
disease exists, and that therefore by us, for all 
practical purposes, the totality of the symptoms 
must be regarded as equivalent to, and identical 
with, "the disease." Let, then, the bugbear of a 
disease as distinct from the totality of the symp- 
toms never more haunt your path-way in practical 
medicine. 

Hahnemann directs us to acquaint ourselves 
with every deviation from the patient's normal, 
healthy condition which we can observe ; to gather 
from the patient's friends and attendants all of a 
similar character that they have observed ; to listen 
to the patient's statement of everything of the 
kind which he has noticed, and of all unusual 
sensations and pains which he has experienced, and 
all unusual phenomena of which Tie has been con- 
scious, whether of body or mind. 

You will perceive that here are two classes 
of phenomena referred to, viz. : such as may be 
observed by the physician or attendants and friends, 
and such as are perceived and can be stated only 
by the patient himself. The former, which may 
be the objects of study and observation by the 
physician, are called objective symptoms. The latter 



30 SYMPTOMS, THEIR STUDY J 

are the subjects of the patient's own consciousness, 
and are styled subjective symptoms. We may notice 
and study the spasmodic twitching of the facial 
muscles, the alternate flushings and pallor in a case 
of facial neuralgia, but the patient alone can make 
us aware of the sensation which he experiences 
simultaneously with those twitchings and flushes. 
In a case of pleurisy we may detect a friction sound 
denoting dryness or roughness of the pleura, or the 
dullness denoting effusion ; we may observe the 
deviation from the natural symmetry of the thorax ; 
the labored and hurried breathing, the short, dry 
cough and the expression of suffering which accom- 
panies it, but the patient alone can tell us that he 
suffers from a stitch in the side, where it is, what 
direction it takes, what provokes and aggravates 
and what relieves it. 

The physician and attendants may notice and 
observe the accelerated yet unsustained pulse, the 
dulled perceptions and sluggish or perverted intel- 
lection, the red, or dry, or cracked and trembling, 
tongue, the elevated and uniformly fluctuating tem- 
perature of body, the tympanitic abdomen, the 
tenderness about the ccecum caput coli and the 
enlarged spleen which characterize a typhoid fever; 
but only the patient could have made known to us 
the failing strength of body, mind and will, the 
peculiar headache and the desolate sense of illness 
which, perhaps many days preceding the com- 
mencement of the doctor's attendance, be^an to 
take possession of him. 



OR, "MOW TO TAKE THE CASE." 



31 



We meet with few cases which do not present 
throughout their course, or at least in some portion 
of it, both subjective and objective symptoms. If 
there be an exception, it is that of some chronic 
affections, consisting exclusively, so far as our obser- 
vations enable us to speak, of pains and abnormal 
sensations. I say so far as our observations enable 
us to speak, for I can hardly conceive of an abnor- 
mal sensation except as coincident with some 
structural change of tissue, although this be so fine 
as to elude our present means of research. 

On the other hand, we meet cases presenting at 
first view only objective symptoms, as for example, 
chronic, cutaneous affections and heterologous for- 
mations. And yet I believe that in every such case, 
if we take a broad enough view of it, including 
the history of the case, we shall find a tradition of 
subjective symptoms. However this may be, and 
whatever may be their relative number, and what 
comparative importance we may be disposed to 
attach to them, these are the two varieties of symp- 
toms which patients present to us. 

Now we may study symptoms under two views, 
with two different objects : First, we may study the 
science of symptoms as a branch of medical science, 
as a department of the science of biology, — much as 
we study physiology, which is the other department 
of biology, — without any view to a practical applica- 
tion of the results of our study, without any reference 
to a proposed application of the therapeutic art, 
without considering how we shall remove the symp- 



1 



32 



SYMPTOMS, THEIR STUDY J 



toms by interposing the action of a drug ; and Second, 
we may study symptoms with reference to the prac- 
tical application of our knowledge in bringing drug- 
action to bear upon the patient's symptoms. 

Let us first consider the study of symptoms as 
an independent department of science. It is one, 
let me say, which has not received the attention 
to which its great importance entitles it. 

The patient is before us, the object of our 
observation and inquiry, just as the healthy human 
being is before us when we study his constituent 
tissues and organs and their respective functions in 
pursuing the sciences of anatomy and physiology. 
We observe his objective symptoms and learn from 
him his subjective symptoms. 

A fact of prime importance for us to remember 
at the outset of our inquiry is this : that as in 
nature there are no accidents, so there can be no 
symptom which is not directly the result of some 
immediate cause operating in the organism of the 
patient ; no abnormal appearance or condition of 
any tissue or organ which does not proceed from 
a modification of its cell structure, its nutrition, or 
of the normal proportion of the tissues which com- 
pose it ; no abnormal sensation experienced by the 
patient which is not the result of some change, 
either appreciable in some tissue of the body, or 
assumed to exist therein, or referred to the indefi- 
nite realm of dynamics, the convenient habitat of 
functional derangement for which we have not as 
yet discovered any structural substratum. 



OR, " H 3W TO TAKE THE CASE." 



33 



No symptom, then, is to be passed over as 
unimportant. We know not how important that 
which now seems most trivial may to-morrow be 
proved to be. This we know, that everything in 
the human organism, as in the universe, moves and 
occurs in obedience to Law ; and when we observe 
the phenomena of nature, we fail of the reverent 
spirit of the true and faithful student, if we pass 
over any phenomenon assuming it to be of no 
account, just because our faculties are so little 
developed that we cannot see that it has any signifi- 
cance. If it be true, as the Lord of Glory tells us, 
that of two sparrows which are sold for a farthing 
not one falls to the ground without our Heavenly 
Father, that the very hairs of our head are num- 
bered, how can it be that changes of tissue or of 
excretion or secretion should occur, that abnormal 
sensations should be experienced save in accordance 
with some law of the organism? The noble sentiment 
of the Latin poet, " I am a man : Nothing that is 
human can be alien to me," is true in a physical 
no less than in a moral sense. 

It is our object to observe everything that is a 
deviation from the healthy condition. We must then 
keep up, during our observation, a constant recol- 
lection of the condition of organs and tissues, and 
the performance of function in the healthy subject; 
and our observation will be a sort of running com- 
parison. 

Our object is to note every deviation. We 
must necessarily follow some method in our inves- 
II —4 



34 SYMPTOMS, THEIR STUDY J 

tigation, otherwise among such a multitude of 
objects some would surely escape us. if it be 
necessary for a dog in hunting to scour a field 
according to a certain method of lines and angles, 
surely method must be needful when we are beat- 
ing up this complicated field of the human organism, 
and that too in search of game which does not 
start up at our approach. 

We may adopt the regional method and survey 
the whole body, passing from region to region in 
anatomical order. This is a valuable method and 
indispensable to a certain extent. It fails, however, 
to give us sufficient information respecting organs 
and tissues which, from their situation, are entirely 
removed from our physical examination or explora- 
tion, as, for example, the kidneys and the ovaries. 
The anatomical method of investigation must be 
supplemented by what I may call for a moment, 
somewhat incorrectly, the physiological method. 
By this we seek to arrive at the condition of an 
organ or its tissue, or of the parts of an apparatus 
by examining how it performs its functions. Thus, 
by examining the excretions of the kidney we form 
some conclusion respecting the condition of that 
organ. If we find albumen and certain microscopic 
objects in it, we may be certain that a portion of 
the kidney has become changed in a very definite 
way, which, however, we could not otherwise 
recognize during the life of the patient. The same 
is true of many other organs. 

This knowledge has been obtained by accumu- 



OR, "HOW TO TAKE THE CASE." 



35 



lated observations of the symptoms of diseases, and 
of the results of diseases as noticed after death. 
But so difficult is the art of observation, and so 
hard is it to obtain from patients all of their sub- 
jective symptoms, for the reason that patients have 
not been trained to the observation of natural 
phenomena, and are not good observers even of 
themselves, that we should hardly succeed in get- 
ting- all the symptoms of a case if we did not add 
to the regional and the physiological another mode 
of observation. The history of disease has taught 
us that when certain symptoms are present in 
some one organ or apparatus of the body, there 
are almost sure to be present certain other symp- 
toms, objective or subjective, in other organs often 
anatomically quite remote, and of which the patient 
probably is hardly aware until his attention is 
called to them by the physician. 

I may cite as examples the fact that certain 
pains in the head, persistently experienced by the 
patient, are found, by observation of a great many 
patients, to co-exist with certain uterine affections, 
of the existence of which the patient was hardly 
aware ; and the immediate symptoms of which 
would probably have been overlooked in the recital. 
Another noteworthy instance, a recent discovery, 
is the coincidence of a certain morbid condition of 
the retina with a form of Bri^ht's disease of the 
kidney, to which attention may thus be called at 
an earlier stage than that at which the kidney 
symptoms would have discovered it. 



36 



SYMPTOMS, THEIR STUDY; 



To recapitulate, then : we observe the changes 
in form • and structure which are open to our 
senses, we use whatever methods we possess to 
discover others ; we illuminate the interior of the 
eye, the rima of the glottis, the canal of the 
urethra, the meatus of the external ear. We sound 
the thorax and the abdomen by the methods of 
percussion and auscultation ; we analyze the secre- 
tions and excretions, and reason from the results — 
through our knowledge of the history of disease 
— to a conclusion respecting the condition of 
organs and tissues hidden from our observation. 
Thus we obtain our complete series of objective 
phenomena. ' 

We then address ourselves to the task of taking 
the subjective symptoms of the case. Availing 
ourselves of the regional method which investigates 
in topographical order one region of the body 
after another; the physiological method which traces 
sensations from one organ to another, and leads 
us to look for sensations or even objective symp- 
toms in some part of the body because we know 
them to exist when certain others are present ; 
and, finally, employing our knowledge of the history 
of disease to trace symptoms, both subjective and 
objective, from one organ and apparatus to another, 
we make up our series of subjective phenomena. 

Now, it may occur to some of you that when 
I speak of the modifications of tissues and organs 
found in the patient, and of the necessity of exactly 
observing and studying them, I am advocating the 



OR, " HOW TO TAKE THE CASE." 



37 



study of pathological anatomy ; and that in show- 
ing how a study of the connection of symptoms in 
the patients may greatly facilitate the discovery of 
symptoms by showing their mutual connection, 
dependence and succession, just as the study of 
physiology enables us to grasp the phenomena of 
the healthy organism, I am defending the study of 
pathology. And so I am. For just here we have 
the province of pathology and pathological anat- 
omy, which are indispensable instruments in the 
study of symptoms. Let us not be frightened from 
their legitimate use for the reason that they have 
been put to a false use. 

If we disregard these auxiliary sciences, our col- 
lections of symptoms must be for us incomplete lists 
of unmethodized and unarrano-ed observations. How 

o 

can we imagine that any department of medical 
science can exist and be pursued which would not 
be a useful auxiliary to the physician ? 

Let us turn now from this glance at the inde- 
pendent study of symptoms as a science, to their 
study as the means to a practical end. As prac- 
titioners of medicine, what is our object in collect- 
ing and studying symptoms? 

If we regard our duties to our patient in the 
order in which they were stated in my last lecture, 
that we are to ascertain for him where and what 
he ails, whether and how soon he can recover, and 
finally what will cure or help him, we study symp- 
toms, first of all, to form our diagnosis. Viewed 
with this object, the symptoms we have 'obtained 



38 



SYMPTOMS, THEIR STUDY J 



from the patient at once classify themselves in our 
minds. Certain symptoms take front rank as indi- 
cating the organ which is chiefly affected, and the 
kind of deviation from a healthy state which exists 
in it. Such a symptom is called pathognomonic ; 
and is entitled to that epithet if it be found only 
when a certain diseased condition exists, and always 
when that condition exists. We cannot pronounce 
a symptom to be pathognomonic, nor recognize it 
as such, unless we are acquainted with the history 
of disease. Then we require to form our prog- 
nosis. Here again we must have a knowledge of 
the history and course of disease, that we may 
recognize any symptoms which indicate a lesion so 
extensive that recovery is unusual or impossible. 
We must know, likewise, the history of disease, as 
its course is capable of being modified by medical 
treatment, and by different varieties of medical 
treatment. 

Third: Our object in the study of symptoms 
is to get into position to ascertain what drug shall 
be applied to cancel the symptoms and effect a 
cure. This is the practical end. 

The homceopathist obtains his series of symp- 
toms, and then, in accordance with the law, similia 
similibus, he administers to the patient the drug 
which has produced in the healthy the most simi- 
lar series of symptoms. 

Now, in speaking of the independent study of 
symptoms as a science by itself, I have urged the 
necessity of eliciting all of the symptoms, both 



OR, " HOW TO TAKE THE CASE." 



39 



objective and subjective, bringing every auxiliary 
science to aid in the search for symptoms. But 
when we come to the practical application of the 
law, Sim ilia similibus euratitur^ when we come to 
place side by side the two series of symptoms, 
those of the patient and those of the drug respect- 
ively, it is manifest that those of the patient to 
which we find nothing corresponding in the symp- 
tomatology of the drug, are of no use to us in 
the way of comparison. Practically, then, unless 
the observation of symptoms as produced by drugs 
in our provings is developed pari passu with that 
of symptoms as observed in sickness, there will 
be much of which practically we can make no 
use. And you will find this view to explain much 
that is said in disparagement of the study of 
pathology and pathological anatomy, and of any 
aid which they may afford to the practitioner. 

The difficulty resides in the present imperfec- 
tion, respectively, of the sciences of pathology, 
symptomatology and pathogenesy. 

Of the symptoms which we have obtained from 
our patients, the question of their relative value 
must occur to you. I have mentioned pathogno- 
monic symptoms and their supreme value as deter- 
mining the diagnosis. Are they as valuable when 
we are in search of the right remedy? To answer, 
let us see what we are doing. We are seeking 
that drug of which the symptoms are most similar 
to those of the patient. We may have seen in 
our lives a hundred cases of pneumonia. Every 



4o 



SYMPTOMS, THEIR STUDY J 



one of these presented the symptom which is 
pathognomonic of pneumonia. And yet the totality 
of the symptoms of each patient was different, in 
some respects, from that of every other pneumonia 
patient. And this must necessarily be so, because 
the diseased condition of each patient is the result- 
ant of two factors, the morbific cause, assumed to 
be the same for all, and the susceptibility or irri- 
tability to that cause, which susceptibility may be 
assumed to be different for each; the resultant 
must be different for each. We must look, then, 
for the symptom which shall determine our pre- 
scription in some other symptom than the path- 
ognomonic, in some symptom which from the 
diagnostic point of view is far less important, in 
some subjective symptoms, or in a condition which 
individualizes. 

Is it essential that the pathognomonic symptom 
of the case should be present among the symptoms 
of the drug? Theoretically, it certainly is. Prac- 
tically, in the present rudimentary condition of our 
provings, it is not. We attain a brilliant success 
if not a certain one, where it has never been 
observed; although I think we are bound to 
assume, and are justified in assuming, that were 
our provings pushed far enough it would be pro- 
duced. This subject will come up again hereafter. 

Recalling now the practical division made of 
symptoms into objective and subjective, the ques- 
tion presents itself: Do we, in the practical use of 
our symptom series, make use of objective symp- 



OR, " HOW TO TAKE THE CASE." 



41 



toms as in the independent study of symptoms? 
Unquestionably, wherever the character of our prov- 
ings has made this possible, and indeed wherever 
clinical observation has supplemented the provings. 

In skin diseases, wherever we meet the well- 
defined, smooth erysipelas of Belladonna, or the 
vesicular erysipelas of Rhus, or the bullae of Eu- 
phorbium, or the cracks of Graphites, or the lichen 
of Clematis, or the intertrigo of Lycopodium, or 
the hard scabbed ulcers of Mezereum, from the 
edges of which thick pus exudes on pressure, — do 
not these symptoms almost determine our selection 
of these remedies ? Or the white tongue of Pulsa- 
tilla, the red-tipped, dry tongue of Rhus, the moist 
trembling tongue of Phosphoric acid, the broad, 
pale, puffed and tooth-indented tongue of Mercu- 
rius solubilis, the yellow coat at the base of the 
tongue of Mercurius proto iodatus, or the patchy 
tongue of Taraxacum, — do we not recognize these 
symptoms as most important indications for these 
remedies respectively ? Shall I further mention the 
objective symptoms, — sandy grains deposited in the 
urine, or a red deposit which adheres to the vessel, 
or the various peculiarities of feculent excretion and 
of sputa, which are well-known and universally 
admitted indications of certain remedies, or the 
radial pulse, or the heart rhythm ? 

It appears, then, that objective symptoms are 
valuable indications for the remedy, just in propor- 
tion as they have been observed in proving drugs, 
so as to afford a ground of comparison ; and just 



42 



SYMPTOMS, THEIR STUDY J 



in proportion as the observation has been precise 
and definite, enabling us to distinguish one case 
from another, or, as we term it, to individualize the 
case. 

Such is the value of objective symptoms. But, 
our object being to individualize the case, it fre- 
quently, indeed generally, happens that the distinct- 
ive symptoms are subjective. 

How now shall we examine the patient to get his 
symptoms? Do you say that this is an easy mat- 
ter ? Gentlemen, it is the most difficult part of 
your duty. To select the remedy after a masterly 
examination and record of the case is compara- 
tively easy. But to take the case requires great 
knowledge of human nature, of the history of dis- 
ease, and, as we shall see, of the materia medica. 

We see the patient for the first time. If the 
case be an acute one, it may be that at a glance 
and a touch we shall observe certain objective 
symptoms which, at least, help us to form our 
diagnosis, and constitute the basis of the picture 
which leads us to the choice of our remedy. 

Further examination reveals other objective 
symptoms. For others, as well as for subjective 
symptoms, we must depend on the testimony of 
the patient and his attendants. We have then to 
listen to testimony, to elicit more testimony by 
questioning and cross-questioning the patient and 
his friends, and to form conclusions from their 
evidence. We have to weigh evidence, and here 
we encounter a task which is similar to that of the 



OR, "PIOW TO TAKE THE CASE." 43 

lawyer in examining a witness, and success in which 
requires of us obedience to the rules for the col- 
lection and estimate of evidence. We must study 
our witness, the patient; is he of sound under- 
standing? may we depend on his answers being 
true and rational? He may be naturally stupid or 
idiotic, he may be insane, he may be delirious 
under the effect of the present illness. Or, putting 
out of view these extreme suppositions, is the 
patient disposed to aid us by communicating freely 
his observations of himself, or is he inclined to be 
reticent? You will be surprised at the differences 
in patients in this regard. Some meet you frankly, 
conscious that by replying fully, and by stating their 
case carefully, they are aiding you to help them. 
Others act as if they felt that in meeting the 
doctor they have come to an encounter of wits, in 
which they are determined that their cunning shall 
baffle his shrewdness. Others again are morbidly 
desirous of making themselves out very sick, and 
will unconsciously warp their statement of their 
symptoms so as to justify their preconceived notion 
of their case ; and if you question them, however 
you may frame your question, they will reply as 
they think will make out the case you seem to 
apprehend. Others, on the contrary, so dread to 
give testimony which, they fear, may make it 
certain that they have some apprehended disease, 
that they cannot bring themselves to state facts as 
they are, but twist and misstate them as they fain 
would have them. 



44 



SYMPTOMS, THEIR STUDY ; 



I might pass without mention the case of those 
who deliberately conceal or deny the existence of 
symptoms which would betray the presence of 
diseases of which, with abundant reason, they are 
ashamed, because, I take it, you will be minded to 
have no dealings with those who refuse to their 
physician their unlimited confidence. 

There is another class whose statements are 
plus or minus what exactness would require. 
Almost all of our descriptive language is figurative. 
We describe sensations certainly according to our 
idea of what effect would be produced by certain 
operations upon our sensory nerves, e. g., burning, 
boring, piercing. This involves an act of the 
imagination. We are differently endowed with the 
imaginative faculty. Some persons cannot clothe a 
sensation in figurative language, and are therefore 
almost unable to describe their subjective symptoms, 
and are very difficult patients. Others, again, 
naturally express themselves in this wise, and, 
where imagination is controlled by good judgment, 
are excellent patients, because they describe their 
symptoms well. This is a matter dependent upon 
natural endowment, and not upon education or 
culture. Some persons who cannot construct a 
sentence grammatically will give us most graphic 
statements of symptoms ; while others who have 
borne off the honors of a university are utterly at a 
loss for the means to express what they feel. 

Finally, some persons have a natural fervor 
and tropical luxuriance of expression, which leads 



OR, "HOW TO TAKE THE CASE." 



45 



them to intensify their statements and exaggerate 
their sensations. And some, like the Pharisee who 
believed he should be heard for his much speaking, 
think to attract our attention, and excite us to 
greater effort in their behalf, if they magnify their 
sufferings and tell us a pitiful tale. Others, on the 
contrary, of a more frigid temperament, give us a 
statement unduly meagre in its Arctic barrenness ; 
or else, fearing to seem unmanly if they complain 
with emphasis of suffering which is perhaps the 
lot of all men, understate their case and belittle 
their symptoms. 

In estimating your patients in these regards, 
judging while the tale is being told what manner 
of man you have to deal with, what allowances you 
must make, what additions, what corrections, you 
will have full scope for your utmost sagacity and 
savoir /aire; and of the value of this estimate 
of your patient I cannot speak too highly. I have 
often seen the thoroughly scientific man led astray 
and bamboozled, where one far inferior to him in 
scientific knowledge detected the peculiarities of 
the patient, made the necessary corrections, got an 
accurate view of the case, and then the prescription 
was easy. Why, sometimes the patient will, in 
good faith, state a symptom so incompatible with 
others that we know and must declare it impossible, 
and so it is finally admitted to be by the patient. 

If it be necessary to make this estimate of the 
patient, so must we likewise of his friends, who, 
besides having the peculiarities already spoken of, 



4 6 



SYMPTOMS, THEIR STUDY ; 



may be unfriendly to us or to our mode of treat- 
ment, and may thus be reticent or reluctant 
witnesses, or may even mislead us willfully. 

We make this estimate of our patient and his 
friends while he and they are stating the case to 
us ; and this statement we should as far as possible 
allow them to make in their own way, and in their 
own order and language, carefully avoiding inter- 
ruption, unless they wander too far from the point. 

We must avoid interrupting them by questions, 
by doubts, or even by signs of too ready 
comprehension of what they are telling us. It 
will of course happen that they skip over im- 
portant details, that they incompletely describe 
points that we need to understand fully. But 
we should note these as subjects for future 
questions, and forbear breaking in upon the train 
of our patient's thoughts, lest once broken he may 
not be able to reconstruct it. When he has finished, 
we may, by careful questioning, lead him to supply 
the deficiencies. We must avoid leading questions, 
and at the same time must not be so abstract and 
bald that for lack of an inkling of our meaning, 
the patient becomes discouraged, and despairs . of 
satisfying us. It is never our object, as it may be 
that of the lawyer, to show our own cleverness at 
the patient's expense, and to bamboozle him. We 
must, on the other hand, make him feel, as soon 
and as completely as possible, that we are his best 
friend, standing there to aid him in so reviewing 
his case that we may apply the cure. And so we 



OR, " HOW TO TAKE THE CASE." 



47 



must encourage his diffidence, turn the flank of his 
reticence, lend imagination to his matter-of-fact mind, 
or curb the flights of his fancy, as may be required. 

We want a statement of the case in graphic, 
figurative language, not in the abstract terms of 
science. It does not help us to hear that the 
patient has a congestive or an inflammatory pain 
(however correct these conceptions may be) ; but 
a burning or a bursting pain is available. Nor 
does it specially enlighten us to know that the 
patient feels now just as he did in last year's 
attack, unless indeed we attended him then. 

Having received the patient's statement and 
made our own observations, we have a picture of 
the case, more or less complete. What are we to 
do with it ? What is the next step ? We have 
now one series of phenomena. The law tells us 
that the drug which will cure that patient must be 
capable of producing in the healthy a similar series 
of phenomena. 

Seeking the means to cure the patient then, 
we look among drug provings for a similar series 
of phenomena. Let us suppose that w r e find one 
which corresponds pretty well. Not exactly, how- 
ever, for here are certain symptoms characteristic 
of that drug, of which the patient has not com- 
plained. We examine the patient as regards those 
symptoms. No ! his symptoms in that line are 
quite different. We try another similar drug, com- 
paring its symptoms with the patient's, and ques- 
tioning the patient still further; and thus the 



48 SYMPTOMS, THEIR STUDY. 

comparing and trying proceed until we find a fit. 
This is a mental process, so expeditious sometimes 
that we are hardly aware how extensively we 
eno-acre in it. But it shows how difficult it is to 
take a case unless we have some knowledge of 
the materia medica, and how much an extensive 
knowledge of materia medica aids us in taking the 
case; and this explains why the masters in our 
art have given us such model cases. (In consulta- 
tions, a doctor will send his taking of the case. 
We cannot prescribe from it. We must take the 
case ourselves.) In thus fitting the case and the 
remedy be honest with yourselves, just as in getting 
shoes for your children. Do not warp or squeeze 
to make a fit. 

And now, before we go further, let us ask 
what are the symptoms generally which give the 
case its individual character, and determine our 
choice of the remedy. Are they the pathognomonic 
ones? They cannot be unless we are to treat 
every case of disease named by a common name 
with one and the same remedy. Are they those 
which are nosologically characteristic ? No, for the 
same reason. They are the trifling symptoms, 
arising probably from the peculiarity of the indi- 
vidual patient, which make the case different from 
that of the patient's neighbor. They may be a 
sensation or a condition. If it be metrorrhagia, 
the mere fact that the flow is worse at night may 
determine the choice between two such remedies 
as Calcarea and Magnesia. 



THE ANAMNESIS. 



IN my last lecture I tried to explain the nature 01 
the series of symptoms which make up a case 
of sickness ; the different kinds of symptoms, and 
how to observe and get a knowledge of them; the 
different value of symptoms, depending on the 
object which you have in view when you are 
studying them. I endeavored to show the impor- 
tance of an independent study of symptoms as a 
distinct branch of the science of biology, without 
reference to the practical application of the art of 
curing. And, finally, I showed how the totality of 
the symptoms when obtained, was practically made 
available for the selection of the remedy, by being 
compared with the symptoms produced by drugs 
in the healthy subject ; that drug being selected 
which had produced symptoms most similar to those 
of the case ; and I showed how it must be that 
sometimes it is apparently trivial symptoms which 
determine the choice between one and another 
drug. 

It may have occurred to some of you, as it 
must have occurred to all who, having had practical 
"— 5 



50 



THE ANAMNESIS. 



experience in the homoeopathic treatment of disease, 
did me the honor to be present at my lecture, that 
I took no notice of a very important feature in 
the examination of the case, — a most important 
element of the case.. — viz. : the previous history 
or the anamnesis, as it is called. 

As a matter of course, in our investigations 
for the purpose of. forming a diagnosis and a 
prognosis, the previous history of the case and 
of the patient before he became ill must have 
received our earnest attention. But it has not yet 
appeared, from what I have said, what part the 
history of the case is to play in enabling us to 
select the appropriate remedy. To this subject, as 
it is both very important and not always clearly 
understood, I shall devote much time this morning. 

You will please bear in mind that the process 
by which we accomplish the selection of the remedy 
for a case of sickness, is a process of comparison. 
We compare the symptoms of the case with the 
symptoms which drugs have produced in the 
healthy; and we select the drug of which the 
symptoms are most similar to those of the patient. 
We seek a parallelism between drug symptoms and 
those of the patient. 

You will remember also that the symptoms of 
a case of sickness, like the physiological phenom- 
ena of persons healthy, are not always and during all 
time the same; they vary from day to day, from 
hour to hour, or from minute to minute. Indeed it 
might properly be said that life is, in so far as every 



THE ANAMNESIS. 



51 



physiological process is concerned, a series of 
oscillations within physiological limits ; now action 
is vehement, now mild ; waste is now in excess, 
now in deficit. Just so is it with morbid phenom- 
ena or symptoms, whether they be of natural, or 
of artificial or drug, disease. We are then insti- 
tuting comparisons between, so to speak, oscillat- 
ing and continually shifting series of phenomena. 
Now, the point of importance here is that this 
oscillation and shifting require time, and that there- 
fore our summary of the symptoms must cover not 
merely the moment of time at which we observe 
the patient, but also some previous time during 
which the symptoms may have been different from 
those of the present time. This remark applies 
both to the drug and the case. It is necessary 
not simply for the purpose of getting a full picture 
of the case, but also to make certain that there is 
a complete parallelism between the case and the 
drug we think of giving the patient. 

Two lines, each an inch long, may appear to 
be parallel. If we would be certain whether or 
not they are so, let us project each line until it is 
a foot long. We shall then more easily see the 
divergence or convergence if there be any. Just 
so, at some particular moment, the symptoms of a 
case and of a drug may appear to be very similar ; 
but if we compare the succession and order of the 
symptoms, for the space of a day or two, with the 
succession and order of the drug symptoms, we 
may notice a marked difference. This is illustrated 



52 



THE ANAMNESIS. 



by comparing the symptoms produced by two 
drugs in the healthy prover. There is a period 
in the action of each, when, to my mind, the 
symptoms of Aconite and Carbo vegetabilis are 
very similar, and yet, taking a broader view of 
these drugs, we can hardly find any more unlike. 

Shall I shock any of my hearers by stating this 
necessity for taking into consideration the course 
and succession of symptoms in selecting a remedy ; 
and shall I be told that strict homoeopathy requires 
that a prescription shall be made for the symptoms 
that are present, the remedy to be changed when 
the symptoms change ? I believe that some con- 
scientious physicians too closely follow this method — ■ 
too closely for the best success. Let us take a 
practical instance ; a case of intermittent fever. 
The patient has certain symptoms which precede 
and usher in the chill. Then, for two hours or 
more, he has the symptoms which constitute the 
chill ; then, after an interval, those which constitute 
the hot stage ; then those of the sweating stage ; 
after which comes a period of from ten to forty 
hours, constituting the apyrexia, during which the 
patient probably may have some symptoms which 
serve to characterize his case, and individualize it. 
We may see the patient during one or all of these 
periods. His symptoms at the different times are 
certainly very different. Is it our custom, is it good 
practice, to give the patient a different remedy, 
corresponding to each of these stages ; or, would 
the nicest faculty of selection lead us to select for 



THE ANAMNESIS. 



53 



each stage the same remedy, to which a survey of 
the whole case would bring us ? The former is 
not our custom. It would not be good practice. 
We could not so select. On the contrary, we 
extend our lines of symptoms — unless they corre- 
spond with the complete paroxysm and apyrexia — 
and then we can judge of their parallelism. We 
seek a remedy which produces just such cold, hot 
and sweating stages in just such order and with 
just such concomitant symptoms, and that likewise 
produces such symptoms in the apyrexia. Do you 
point me to cases in which no such parallelism is 
found, and yet a successful prescription is made ? 
I reply that, as I said at first, we are like the 
Israelites, and must make bricks whether we have 
straw or not. We must prescribe from our materia 
medica as it is. Where we can do no better, we 
must prescribe on a few symptoms, on an inference 
or an analogy, rather than refuse to prescribe at 
all. Yet nobody will deny the greater certainty of 
the prescription when such a parallelism can be 
established. In such a case, then, we follow the 
patient along a series of violent oscillations between 
cold, heat, sweat, and the normal state again. And 
this we do, to a greater or less extent, in very 
many illnesses in which the oscillations are not so 
violent. 

I believe that a broad enough consideration of 
this subject would lead physicians to abstain from 
alternation of remedies even in the few instances 
in which Hahnemann sanctioned it, and would deter 



54 



THE ANAMNESIS. 



them from the error, as I deem it, of leaving" a 
patient several remedies to be taken, variously, as 
different phases of sensation or objective phenom- 
ena succeed each other. But to be able to pre- 
scribe in this large-viewed way for your patient, 
you must have studied the materia medica in the 
same comprehensive way ; you must have studied 
the connection and succession of the symptoms. 
A mere repertory study for the case in hand will 
not suffice. You must have made a systematic 
study of each drug and of each group of drugs. 

Now I see no reason, especially in chronic dis- 
eases, why this method of taking into consideration 
the oscillations of symptoms should be limited to a 
few days or a week. If a patient present himself, 
having a fever at night and chilliness by day, we 
comprise these oscillations in one group, and seek 
a remedy which presents a parallel group. If, 
now, we find a patient who has a certain set of 
symptoms in the summer, which uniformly gives 
place to another set in the winter, and these again 
are replaced, in turn by the summer set, why 
should we of necessity restrict our view in the 
summer to the symptoms of that season only, and 
in winter the same, when we might by a broader 
view comprehend both under one prescription ? It 
is a practical question. Can it be done ? I answer 
from experience, it can ; and let me tell you an 
advantage. The symptoms of one season may be 
so vague and indefinite that you cannot find a 
remedy for them, just as in the intermittent the 



THE ANAMNESIS. 



55 



symptoms of one stage may have so little about 
them that is characteristic that you cannot select a 
remedy. But, perhaps, the symptoms of the other 
season, the summer, are so characteristic as to 
leave no doubt of the remedy. Then, if you 
believe - in this unity of disease, you may in the 
winter prescribe on the strength of the summer 
symptoms, although these disappeared months ago 
and will not recur for months to come, and you 
may effect a radical cure. I shall presently illus- 
trate this by a case. 

Let me say further, that if this be a correct 
method of prescribing, we may extend it, and 
instead of requiring a succession of oscillations, 
even at so distant intervals as summer and winter, 
we may regard an acute attack of illness and the 
chronic condition which follows it as one series of 
phenomena, and prescribe as for one present 
malady, even though years have passed since the 
acute attack of illness was merged into the chronic 
affection. I shall illustrate this point by two cases. 

I come now to a third kind of case, in which 
a family predisposition to the recurrence of a cer- 
tain form of disease at a certain period is so 
marked, that we may consider indefinite and vague 
symptoms as indications that the tendency is work- 
ing to development, and may prescribe for it in 
anticipation. I should not venture upon this state- 
ment had I not a case to present in illustration 
of it. Let me repeat that the advantage of these 
methods lies in the fact alone that they give us 



56 



THE ANAMNESIS. 



data for a sure prescription, whereas otherwise we 
should be unable to find a basis for a prescription. 
I will now relate cases. 

1. E. W. D. Headache in winter, nondescript 
diarrhoea in summer, indicating Aloes. I prescribed 
Aloes in the winter, on the strength of the summer 
diarrhoea, and cured both. 

2. The case of G. W. W., jr. Deafness from 
milk-crust. I prescribed Mezereum for the milk- 
crust, and the deafness never returned. He is now 
attending to business. 

3. A case of epilepsy. I prescribed Platina, 
on the strength of previous strong passion and 
peculiar disposition ; imperious and high stepping. 

4. The case of Mrs. B. was one of supposed 
uterine disease ; she had been treated by caustics, 
etc. She complained of aching in the heels, and 
I suggested Agaricus. The whole family had 
spinal meningitis ; two brothers had died, and a 
sister was paraplegic. Agaricus cured the uterine 
disease. 



PULSATILLA. 

ANEMONE PRATENSIS. PULSATILLA NIGRICANS. 

I HAVE chosen this drug to commence a course 
of lectures on materia medica, as well because 
it has been very thoroughly proved and verified by 
clinical experience, as also because it is one of 
our chief polychrests. 

Polychrest is a term applied to a number of 
the remedies that are the most frequently used in 
practice, and that have an extensive range of 
application. 

It would be an error, however, to suppose that 
a polychrest, which is called for every day, is any 
more useful in any given case than a drug that 
we are required to give only once a year will be 
in the case which requires it. It must never be 
forgotten that every case requires just the identi- 
cal remedy which is most homoeopathic to it, even 
if it be a rare and seldom used remedy ; and that 
no other remedy, however popularly or however 
constantly in use, can be as good as, or can take 
the place of, this homceopathically indicated remedy. 

But just as some diseases are very common, 
being met with every day, such as dyspepsias, 



58 



PULSATILLA. 



bronchial catarrh, diarrhoea, ephemeral fever, etc., 
so there are certain remedies which produce, when 
proved upon the healthy, series of symptoms simi- 
lar to those of these frequently recurring diseases. 
It is obvious that these remedies will be frequently 
indicated in practice, will be often used and in 
many cases. These remedies are our polychrests. 
We must know them well ; although it is of great 
importance that, in bending ourselves to the study 
of them, we neglect none of the other remedies of 
out materia medica. 

In studying Pulsatilla and all other remedies, 
we shall follow Hahnemann's anatomical order, 
stating the symptoms of each region in succession ; 
and calling attention to the conditions of aggrava- 
tion and amelioration, and to the simultaneous 
manifestation of groups of symptoms in different 
regions. We shall then take a general view of 
the remedy, endeavoring to appreciate its charac- 
teristics and its special spheres of action. Finally, 
we shall consider its more obvious applications to 
diseased conditions frequently met with, its resem- 
blance to other remedies, and the differences 
between them. 

We begin with the 

Sensorium. Pulsatilla produces vertigo or dizzi- 
ness, which occurs while sitting, but is relieved 
while walking or sitting in the open air; dizziness 
when directing the eyes upward, and especially 
when stooping, when it seems as though the head 
were too heavy ; a drunken dizziness, the head 



PULSATILLA. 



59 



feeling hot inwardly, and the face pale. The ver- 
tigo occurs or is worse in the evening or after 
eating. We here meet conditions which we shall 
find to pervade the Pulsatilla proving, and to be 
characteristic of the drug, viz. : occurrence or 
aggravation of the symptoms in the evening, after 
eating, during repose, and amelioration from motion 
and from being in the open air ; also paleness of 
the face, even with sensation of internal heat. 

Head. The headache is chiefly in the fore- 
head and supraorbital region, and in the temples. 
The pains are a heaviness, a bursting sensation in 
the temples, and throbbing. These sensations are 
aggravated by stooping, by mental exertion, and in 
the evening, and by rolling the eyes upward. 
Occasional stitching pains in different parts of the 
head, frequently confined to one half of the head. 
Indeed, this is a peculiarity of Pulsatilla pains gen- 
erally, that they are often confined to one half of 
the body, like those of Ignatia, Thuja, Spigelia, 
Valeriana and Silicea. 

[Helonias dioica has a pressing pain in one or 
both temples -(in a small spot), a "burning sensa- 
tion " in the top and front of the head, which is 
entirely dispelled by motion and mental exertion. It 
comes on immediately when either the motion or 
mental exercise is desisted from. — S. A. Jones, 
M. D.] 

It may be added that a Pulsatilla headache is 
generally coincident with disturbances in other 
regions of the body, as, for example, the digestive 



6o 



PULSATILLA. 



tract, or the genito-urinary organs, especially the 
latter in females. 

Eyes, Eyelids. The margins are inflamed ; hor- 
deola form upon them. Further, the lids are dry and 
scurfy — in the morning they are agglutinated. In 
the eyes themselves the pains are : stitching, and 
especially itching and severe aching, with a sensa- 
tion as if a foreign body were in the eye, or a 
veil before it which could be winked away. There 
is great lachrymation in the open air, and consider- 
able photophobia. 

Vision is obscured, but it is to be noted that 
this obscuration is conjoined with vertigo and 
nausea, whence we may infer that it is functional 
and not dependent upon organic lesions of the 
eye. The same may be said of the other symp- 
toms of vision ; fiery circles, and starry apparitions, 
and double vision. Nevertheless, these symptoms 
are not to be ignored, for they individualize and 
characterize the disturbance in other organs and 
systems with which they coincide in occurrence. 

Ears. Internally, itching, stitching and tear- 
ing sensations ; also, violent pain like a distending 
or outward-pressing ache. The external ear is hot, 
red and swollen. Discharge of pus from the ear. 

Deafness as though the ear were stopped. 
Murmur and rushing noise isochronous with the 
pulse. 

In front of the ear an eczematoid eruption, with 
a burning-biting pain, and swelling of the cervical 
glands. Stitching pain in the parotid. 



PULSATILLA. 



61 



In ordinary catarrhal otitis, Pulsatilla is our 
best remedy ; i. e., the symptoms of such cases 
most frequently indicate Pulsatilla. Silicea resem- 
bles it closely. 

In deeper-seated inflammation of the cellular 
tissue, Mercurius or Silicea or Rhus is called for. 
Tellurium corresponds to a peculiar affection of 
the meatus auditorius externus and the external 
ear. 

Chamomilla indications differ from those of Pul- 
satilla in the symptoms of the disposition, and 
especially in the great intolerance and impatience 
of pain. 

The same may be said of the Arsenicum ear- 
indications. 

Nose. Superiorly near the inner canthus of the 
eye, an abscess like a lachrymal abscess. The alae 
nasi are ulcerated, so have the nares internally a 
sensation as if ulcerated. There is in the nose a 
smell as of an old catarrh. (It is perhaps this 
symptom which first induced a trial of Pulsatilla in 
ozaena simplex.) 

Mouth. Tongue covered with tenacious mucus. 
A white-coated tongue is an indication for Pulsa- 
tilla. 

Yellow coat at the base of the tongue, Mercu- 
rius protoiodatus. 

Teeth. Two varieties of pain — a stitching or 
digging, worse in the evening or early night ; and 
a drawing, tearing sensation, as if the nerve were 
drawn tense and then suddenly let go. 



62 



PULSATILLA. 



The toothache is renewed always after eating, 
and whenever anything quite warm is taken into 
the mouth. Aggravation by eating and by warmth. 

Chamomilla toothache is aggravated by cold or 
warm food or drink. 

Coffea toothache is controlled by ice-water con- 
stantly in the mouth. (Published by Hale, confirmed 
by me). 

Mercurius toothache is aggravated by cold water 
in the mouth, but relieved by warm. 

Carbo vegetabilis. The whole row of teeth too 
long and very tender ; he cannot bite. 

Causticum. Gum swollen ; feeling as if the 
tooth were being crowded out of the alveoli ; tooth 
too long, aggravation in the evening and by eating. 

Lachesis. Swelling corresponding to the external 
fangs of the upper molar, with swelling of the cheek; 
the skin feels tense, hot and crisp, as if it would 
crack ; throbbing in the cheek. Periodontitis. 

Throat. Sensation, on deglutition, as though 
the uvula were swollen. Apart from the degluti- 
tion, a feeling as if raw and sore in the throat, as 
if the submaxillary glands pressed inward and 
were sore. Sensation of great dryness of the 
mouth, palate and lips ; these parts coated with 
tenacious mucus ; a bad taste in the mouth. 

Digestion. Manifold symptoms. The taste is 
variously perverted and altered — seldom bitter, 
except just after eating or drinking. More fre- 
quently a sour taste. But more characteristic of 
Pulsatilla is the taste of the food returning to and 



i 



PULSATILLA. 



63 



remaining in the mouth long after eating. In fact, 
Pulsatilla makes digestion very slow. 

Hahnemann gives us a symptom in parentheses: 
(Food tastes as if too salt). On the strength of 
this symptom I gave Pulsatilla 200 with entire success 
to a patient convalescent from Chagres fever who 
had become well enough to sit up and walk about 
his room, but had a slight chill every afternoon, 
followed by a flush of fever and a sweat at night; 
no appetite, depression of spirits, little thirst, irri- 
tability and peevishness in place of his usual 
amiability, and a perverted taste so that all food 
prepared for him tasted as if saturated with salt. 
A single dose of Pulsatilla removed the latter symp- 
tom, and within six days all the others had vanished, 
and he rapidly regained strength and vigor, and 
has as yet (ten years) had no return of fever. 

Appetite. Moderate; often a gnawing sensation 
in the stomach as from hunger, and yet no desire 
for any special kind of food. 

Thirst. An almost complete absence of thirst 
is characteristic of Pulsatilla ; Sabadilla resembles 
it in this absence of thirst. 

Nausea or qualmishness at the thought or smell 
of food, especially of fat or rich food, or on 
attempting to eat. The sensation is somewhat as 
if a worm were crawling up the oesophagus ; the 
nausea comes up from the stomach. 

Vomiting of food, especially at night or even- 
ing ; waterbrash and gulping up of water or of 
food into the mouth (regurgitation). 



6 4 



PULSATILLA. 



Epigastrium. Feeling as if a stone lay there. 
(Bryonia has the same.) 

Throbbing in the epigastrium, perceptible to the 
hand laid thereon. A contracting sensation in the 
oesophagus, as if one had swallowed too large a 
morsel of food ; the same sensation extends over 
the hypochondria, then up over the chest, and 
impedes respiration. 

Abdomen. Sensation of tension and fullness 
throughout the abdomen, and involving the thorax 
up to the mammary region. Pinching and cutting 
pains, especially around the umbilicus, worse toward 
evening. 

Much flatulence, as might be expected where 
digestion is so slow as under the action of Pulsa- 
tilla. Flatus moves about in the intestines, causing 
pinching pains, and with rumbling noise ; worse on 
waking or just after supper. 

Externally. The abdominal walls are tender 
to the touch, when sitting, or when coughing, espe- 
cially after an alvine evacuation. 

Stool. A twofold action (which yet we are 
hardly justified in designating as primary and sec- 
ondary effects). Difficult stool, with much back- 
ache and urgency, or frequent desire for stool with 
insufficient evacuation or no faeces, but instead 
thereof, yellowish mucus, sometimes mixed with 
blood. On the other hand, Pulsatilla produces 
diarrhoea at night ; stool consisting of green and 
acrid burning mucus, preceded by commotion in 
the bowels. 



PULSATILLA. 65 

In the frequent desire and effort for stool, and 
the difficulty of evacuation, Pulsatilla resembles 
Nux vomica. The difference is found in the gen- 
eral symptoms. 

The diarrhoea of green mucus occurring at night 
resembles that of Dulcamara, which likewise is noc- 
turnal, and but slightly painful. It, however, is 
ascribable to dampness, and is accompanied by 
rheumatic symptoms ; while that of Pulsatilla fol- 
lows errors of diet, especially pork and fat food 
generally. It is not a free purgation, but rather a 
catarrh of the intestine, with spasmodic action of 
the muscular coat. 

Pulsatilla has painful blind haemorrhoids, with 
itching and sticking pains and soreness. 

Urinary Organs. Pressure upon the bladder, 
as if from flatus. Frequent pressure to urinate, 
and cutting pain during the act of micturition. 
(This diners from Cantharides in that the latter 
has pain after micturition.) Involuntary discharge 
of urine, drop by drop, at night, or on making 
exertion, as walking, coughing, etc. The urine is 
sometimes clear and abundant, and again, scanty 
and with a red or brownish deposit. 

Burning in the urethra during micturition. 

Genitals, Male. Itching of prepuce and scro- 
tum. Testes swollen, hanging low, and painful ; 
tensive and tearing pains. 

Mucus discharge from the urethra, with burn- 
ing during micturition. Increase of sexual desire. 
Pulsatilla has been of service in hydrocele, also 
II.— 6 



66 



PULSATILLA. 



in gonorrhoeal orchitis, but it is not so often called 
for in orchitis as Rhododendron, Clematis, Spon- 
gia, Aurum, or Belladonna. 

Sometimes indicated in gonorrhoea by general 
symptoms rather than local ones. 

Ge7iitals, Female. The decided action of Pulsa- 
tilla upon the female genital system has been 
shown by a large clinical experience. In the 
hypogastric zone, drawing, pressing or constricting 
pains, like labor pains, converging toward the 
pudenda. Such pains are relieved by crouching 
forward. They come, generally, just before the 
menstrual period, are attended by a feeling of 
weight, like a stone, in the hypogastrium, and 
accompanied by chilliness, stretching and yawning. 
The menses are delayed, difficult and scanty, or 
even fail altogether. 

Before the menses, labor-like pains as above. 

During the menses, many symptoms, such as 
weight and downward pressure in the abdomen 
and sacral region; nausea; getting black before 
the eyes ; stomachache and faintings ; all worse 
in the warm room and by much exertion, better in 
the open air. 

Leucorrhcea, of a thick mucus resembling cream. 
It is sometimes acrid, producing a burning pain, 
sometimes bland; most profuse after menstruation. 

Pulsatilla appears to stimulate the action of 
the uterus during labor, when the pains dimin- 
ish and become inefficient. 

Comparisons. Cyclamen and Sepia resemble 



PULSATILLA. 



6? 



Pulsatilla in relation to the menstrual function. 
Nux vomica, which is so analogous in many 
respects to Pulsatilla, resembles it in the scanti- 
ness of the flow, but, true to the spasmodic char- 
acter which distinguishes it, brings on the flow 
too early, and keeps it up for too many days, 
although the total amount of fluid lost is not 
excessive. 

The aggravation of Sepia is before menstrua- 
tion ; of Pulsatilla, during menstruation. 

Under Nitric acid, menstruation gradually passes 
into a leucorrhcea which is brown and thick, and 
finally in a few days becomes a thin, watery, flesh- 
colored, offensive discharge, sometimes acrid. 

Kreosote has a leucorrhcea for five days suc- 
ceeding menstruation, thick mucus, exceedingly 
acrid, causing the pudenda to swell and itch, and 
excoriating the thigh. Micturition exceedingly 
painful. The leucorrhcea smells like fresh green 
corn. 

Borax is indicated by leucorrhcea, acrid, just 
midway between the menstrual periods, with swell- 
ing of the labia and inflammation, and discharge 
from the glands of Duvernay. 

Respiratory Organs. Coryza. From the first, 
a discharge of thick yellow mucus from the nose. 
Sometimes it is green and offensive. Loss of taste 
and smell. 

Throat. Roughness and dryness. Sudden 
hoarseness, without much oppression or cough, and 
equally sudden relief. 



68 



PULSATILLA. 



The hoarseness for which Pulsatilla is so effica- 
cious is capricious, coming and going, and without 
apparently adequate organic cause. That of Caus- 
ticum comes on, or is much worse, from five p. m. 
to midnight, and is accompanied by a teasing, dry 
cough. That of Phosphorus is more constant, and 
conjoined with soreness and rawness of the larynx 
and behind the sternum, and a weight upon the 
chest. That of Carbo vegetabilis has ulcerative 
soreness in the larynx, and a burning pain in the 
lungs after a hard cough. 

[I do not say that these are all the conditions 
and concomitants, but they are frequently met, and 
are characteristic] 

Pulsatilla produces two varieties of cough ; one 
with abundant sputa, consisting of thick yellow 
mucus, sometimes bloody, often of a bitter taste; 
the other dry, occurring chiefly at night. The 
feeling which provokes the cough is a tickling in 
the trachea. I have, for years, hesitated to give 
Pulsatilla for a loose cough, even though it seemed 
well indicated, it seeming to change the loose 
cough into the dry, hard night cough. It produces 
dyspnoea and asthmatic oppression, especially at 
night, with palpitation, especially when lying on 
the left side. 

The sensations in the chest are chiefly tension 
and constriction, in conjunction with the dyspnoea 
and asthmatic symptoms. In the middle of the 
thorax a pain, which frequently occurs in the Pul- 
satilla proving: that of an internal ulcer. 



PULSATILLA. 



6 9 



The mammary glands are swollen and tense. 
Itching of the nipples. 

Back. In the sacral region, pains on assuming 
the upright posture, or on bending backward, as 
well as after sitting, so that one can hardly stoop 
or straighten up. Aching as from fatigue, and a 
pressing as from within outward. Finally, in this 
region, a pain as if luxated when moving ; and 
when sitting, a bruised pain, relieved by motion. 

Considering the action of Pulsatilla upon the 
female sexual organs, causing weight and bearing 
down, with leucorrhcea, etc., it is reasonable to 
ascribe the aching and some other sacral pains to 
this action, and experience justifies this view. 
Other pains are analogous to the rheumatic pains 
of the extremities. 

In the back, drawing, tensive and stitching 
pains, which seem to impede respiration and inter- 
fere with free motion. 

Extremities generally. First, we note tearing 
pains, as for example, in the shoulder-joint, where 
i': compels one to move the arm, and is relieved by 
lying on the painful side. Again, in the muscles 
and bones of the arm, and even in the fingers, 
where it seats itself in the tensor tendons. In the 
lower extremities it appears as a jerking, tearing 
pain, from the hip-joint to the knee when lying in 
bed, or only in the knees when sitting ; or in the 
ankles and extending to the heel, the sole and the 
great toe, where it is a tearing pain. 

Observe the characteristic : compelling the prover 



7° 



PULSATILLA. 



to move the affected part, which is equivalent to 
relief by motion ; and by pressure, which is analo- 
gous to motion. 

Then, drawing pains, affecting the whole length 
of the extremities, occurring at night and during 
repose (often associated with chill). 

Stitching pains occur in the upper extremity, 
especially on moving the arm, as in the shoulder- 
joint and in the deltoid muscle. Likewise a feeling 
of heaviness and paralysis in the arm when trying 
to raise it. Indeed the tired, heavy, aching sensa- 
tion, such as comes from fatigue, and yet is not 
relieved by repose, but is rather aggravated thereby, 
is marked in the Pulsatilla proving. 

Burning itching in the soles of the feet after 
getting warm in bed. This symptom led to the 
successful use of Pulsatilla for effects of frost-bite. 
See Petroleum and Agaricus. 

Fever. Pulsatilla produces many symptoms akin 
to one or other stage of fever. Chilliness predom- 
inates. It accompanies the evening pains of what- 
ever kind, as well as the abdominal pains, the 
gastric disturbances, and especially those of the 
female sexual system. It occurs frequently after a 
meal, and early in the morning. But, in and by 
itself, as an independent symptom, chilliness occurs 
generally in the evening. It may be general or 
partial, affecting the extremities. When heat fol- 
lows the chilliness, if it be only a sensation of heat 
with no objective warmth, there is no thirst ; but 
if the heat be, as it sometimes is, both object- 



PULSATILLA. 



71 



ive and subjective, it is then attended by thirst. 
Remember this, because absence of thirst is said 
to be a characteristic of Pulsatilla, and presence 
of thirst, therefore, to contra-indicate. This is true, 
with the limitation stated. 

Frequently the fever symptoms are complex, 
and much mixed up ; chilliness and heat rapidly 
succeeding each other, or occurring simultaneously 
in different parts of the body, or on the different 
sides of the body ; but these complex symptoms 
occur almost always in the evening or at night. 

Riickert calls attention to the fact that though 
the Pulsatilla symptoms generally are not attended 
by thirst, yet sometimes thirst is present when the 
hot stage is strongly marked ; and he has had 
excellent success in puerperal fever and other 
fevers when thirst was present, the mass of the 
symptoms having indicated Pulsatilla. 

Moreover, the cheeks are often hot and red 
while the back is chilly and the feet cold — a state 
of things often observed when the menses are 
retarded in young women. Again, flashes of heat 
over the whole body, producing great discomfort 
and anxiety. In short, a condition of erethism 
such as may co-exist with a depressed nutrition, — 
an approach to the erethistic form of chlorosis. 

Sweat is abundant, chiefly in the early morn- 
ing, sometimes throughout the night ; often, like 
other symptoms, the sweat is semilateral. 

Sleep. Certain peculiarities of sleepiness and 
sleep are characteristic of Pulsatilla. Sleepiness 



72 



PULSATILLA. 



in the afternoon, such not being the habit of 
the prover. Sleepiness after even a moderate 
meal. The prover does not feel sleepy in the 
evening ; on the contrary, wide awake ; ideas 
throng, the fancy is brilliant ; he (or she) does 
not wish to go to bed, and, on going to bed, does 
not fall asleep for a long time. The sleep is 
somewhat troubled and restless, with talking, 
frequent waking, with frightening dreams, until 
toward morning, when sleep is more quiet and 
profound, and is most sound just when the time is 
come to get up. The prover wakens dull and 
inert, although not with aggravation of any other 
symptoms. 

This is a great characteristic of Pulsatilla, and 
is almost always present when Pulsatilla is clearly 
indicated by other symptoms. When, therefore, a 
doubt rests upon the selection of Pulsatilla, it is 
safe to be inclined toward it if the sleep symptoms 
are such as have been described, viz. : wide awake 
in the evening ; does not want to go to bed ; first 
sleep restless ; sound asleep when it is time to get 
up ; wakes languid and not refreshed. 

Pulsatilla contrasts strongly with Nux vomica 
in the sleep symptoms, as in some others. Under 
Nux vomica, the prover is very sleepy and dull in 
the evening, cannot sit up long ; goes to bed early, 
and goes to sleep immediately ; sleeps well until 
about three a. m., then wakes and lies awake, 
thinking, etc., with mind quite clear and active till 
five a. m. ; then dozes and sleeps an hour, and 



PULSATILLA. 



73 



wakes more tired than when he woke at three 
a. m., and often with a headache. 

Sulphur, again, has the evening sleepiness of 
Nux vomica, but the night is full of unrest, toss- 
ing, nervous excitement, orgasm of blood ; pains 
of various kinds, and but little sleep throughout. 

The sleeplessness of Cocculus is from pure 
mental activity, chiefly of memory, and is well 
described by Walter Scott. ("Lady of the Lake," 
U P- 33-) 

Disposition. The disposition is affected by 
Pulsatilla in a very characteristic manner. The 
prover complains of anxiety or distress, as though 
some great evil were impending, and this distress 
appears to him to come from the epigastrium ; and 
with these symptoms come palpitation, chattering of 
the teeth, and flashes of heat ; also, undue anxiety 
about the health or about household duties. In 
addition, there is a marked irresolution, the prover 
cannot determine which of two is the better course 
to pursue ; this is akin to the well-known charac- 
teristic of Pulsatilla, the yielding disposition, which 
gives way under slight opposition, and manifests 
its conscious feebleness by the readiness with 
which tears come to the eyes on slight provo- 
cation. 

The disposition to weep is certainly a strong 
indication for Pulsatilla, but two errors must be 
guarded against, in accepting and applying it. In 
the first place, it must not be considered that a 
lively disposition, and even a considerable amount 



74 



PULSATILLA. 



of spirits and will, contra-indicate Pulsatilla ; laugh- 
ter and tears come often with equal readiness. 

Again, let us remember that the desolate sen- 
sation of utter prostration which ushers in many a 
serious dyscratic disease disposes to tears, espe- 
cially when it comes to a man or person in the 
midst of business or family cares, which he knows 
not how to neglect nor to delegate. If, then, a 
patient, in the incipience of a severe typhoid or 
a diphtheria, can hardly answer the doctor's ques- 
tions for the tears and choking that come, these 
must be looked upon as the physiological result of 
utter prostration of body and desolation of soul, 
coinciding with the consciousness of responsibilities 
and cares too heavy to bear and too precious to 
neglect. They are not especial symptoms of the 
morbid state, nor must they be taken as indica- 
tions of Pulsatilla. I have dwelt upon these points 
because the error referred to is often made, and 
time is thus wasted which can never be regained. 

i GENERAL ANALYSIS. 

i. The most marked disturbances of functional 
activity produced by Pulsatilla are : In the digestive 
apparatus ; the genito-urinary of both sexes, but 
more especially the female ; the respiratory, at least 
as regards the mucous membrane ; and the articular 
synovial surfaces. The mucous membrane through- 
out the body is affected ; as, for example, in the 
middle ear, the eye, nose, throat, bronchi, stomach, 



PULSATILLA. 



75 



intestines, bladder, urethra, vagina, and uterus 
(probably). 

2. Changes in the organic substance are effected 
chiefly in the secretions, and chiefly in those of the 
mucous membrane. The conjunctiva, chiefly the 
palpebral, secretes copiously, and the tears are 
augmented if not modified. The nasal membrane, 
after a brief period of unnatural dryness, secretes 
abundant mucus, which becomes thick, yellow or 
green, and offensive. It is probable that the secre- 
tions of the stomach and small intestines are modi- 
fied, since digestion is so decidedly retarded by the 
action of Pulsatilla, and presents so many abnormal 
features ; such as perverted taste, regurgitation of 
food or its flavor, flatus, pain, etc. ; as well as that 
of the lower intestine, as witness the stool covered 
with mucus, and the mucous diarrhoea. 

So, likewise, the mucous discharge from the 
bladder — as shown by the jelly-like sediment in 
the urine — and the discharge from the urethra, as 
well as the leucorrhcea, attest the modification of 
secretion. 

The special function of menstruation is retarded 
in time, and the secretion (?) diminished in quantity. 
We shall be better able to explain this when we 
understand more about the pathology of chlorosis. 

The testes are the seat of inflammation, pain 
and enlargement, and, although the ovaries were 
not similarly affected in any prover, yet, from anal- 
ogy, Pulsatilla has been successfully used in ovarian 
affection, the symptoms otherwise corresponding. 



76 



PULSATILLA. 



The swelling and heat of the knee and ankle- 
joints, as well as of the small joints of the fingers 
and toes, together with the drawing, tense pain in 
them, and the accompanying symptoms of the 
digestive tract, suggest that Pulsatilla acts upon 
the synovial membranes and upon the nutrition 
much as one form of rheumatism does, and have 
led to its successful use, particularly in rheumatic 
gout, so called. The itching and biting tingling of 
the skin resemble those of measles. 

Peculiarities and Characteristics. Our knowl- 
edge of Pulsatilla being derived wholly from 
provings on the healthy with moderate doses, we 
have no records of the effects of poisonous doses, 
and have therefore no data for constructing a 
theory of its pathological action on an anatomical 
basis ; but, on the other hand, through the action of 
these moderate doses, under the clear observation 
of Hahnemann and his pupils, we have a quantity 
of characteristic symptoms, chiefly subjective, which 
furnish us indications for the selection of Pulsatilla 
more positive and precise than those of almost any 
other remedy. 

Character of Pains. The pains are drawing, 
tearing pains, pains as of an internal ulcer, aggra- 
vated by touch ; but the most peculiar pain is 
a tension, which increases until very acute, and 
then lets up with a snap. The pains occur or are 
much worse at night, before midnight. 

They are accompanied by chilliness, but with- 
out thirst. 



PULSATILLA. 



77 



As the pains increase, the peculiar mental and 
moral Pulsatilla state is more pronounced ; the 
patient loses courage and gets despondent, and 
inclines to tears, and as the pains diminish the 
spirits rise. 

Certain parts of the body become very red or 
purple, without heat, the vessels becoming con- 
gested. This has led to the successful use of 
Pulsatilla in varicose conditions of veins. 

As a general rule, the pains are relieved by 
motion and by cool air, but the abdominal pains 
are relieved by warmth. 

The symptoms which occur when lying still on 
the back are relieved by sitting up and by motion. 
This relief is gradual, however, for the act of rising 
often for the moment increases the pain, and the 
more decidedly the longer one has been sitting 
still. 

Long-continued motion also, like long sitting, 
provokes symptoms, which yet are, for a brief 
period, more evident on first coming to repose. 

The general group of symptoms most charac- 
teristic of Pulsatilla, next to those of the disposi- 
tion, is that of the sleep, which has been already 
detailed. 

Clinical experience has shown Pulsatilla to be 
an excellent remedy for disorders produced by eat- 
ing pork and fat food generally. 

It is often indicated when the menses are scanty 
and delayed. Very frequently, when it fails to bring 
them on, Sulphur will succeed. 



73 



PULSATILLA. 



It is noteworthy that the pains of Pulsatilla 
often occur on one side of the body only. 

Antidotes. For the sleepiness, lassitude, etc., 
Chamomilla. 

For the restless anxiety, etc., Coffea. ■ 
Other symptoms, according to their similarity, 
may call for Ignatia or Nux vomica. 

THERAPEUTIC APPLICATIONS. 

In earache, toothache, headache, ophthalmia, 
palpebrarum, hordeolum, nasal catarrh, bronchitis, 
dyspepsia, nocturnal mucous diarrhoea, gonorrhoea, 
orchitis, vaginitis, prolapsus, rheumatic gout, vari- 
cose veins, measles and continued fever, — in all of 
these diseases when the symptoms correspond. 

Remedies analogous to Pulsatilla may be named 
as follows : 

As to its action on the eye, nose, bronchi and 
skin — Euphrasia, Dulcamara, Sulphur. 

As to its action on the digestive organs — Nux 
vomica, Ignatia, Silicea, Sulphur. 

As to its action on the female sexual organs — - 
Sepia, Murex, Cyclamen, and, above all, Sulphur. 

As to its action on the joints and ligaments — 
Rhus, Sulphur, Ledum palustre. 

As to its action on the veins — Hamamelis, 
Zincum. 

PULSATILLA MITTALTANA. 

An American variety of the Pulsatilla has been 
proved by the Western homoeopath ists and others, 



PULSATILLA. Jg 

and an excellent resume published by Dr. Conrad 
Wesselhoeft in the "Transactions of the American 
Institute of Homoeopathy," 1867. 

The following are the remarks of Dr. Wessel- 
hoeft concerning the European and the American 
Pulsatilla : 

" The resemblance is almost complete in every 
particular. * * * * The European has in a 
marked degree aggravation in the beginning of 
motion and amelioration during continued motion. 
The proving of the American Pulsatilla simply 
declares aggravation during walking, without saying 
whether the symptoms subsided during protracted 
walking." 



CYCLAMEN EUROPIUM. 



SOW - BREAD. 

THE student of materia medica should, at the 
very outset of his career, begin to guard 
against a danger which often besets the physician 
and leads him astray in practice — the danger of 
regarding certain remedies as favorite remedies and 
looking at them with a partial eye ; of allowing 
the high estimate in which he has been, led by his 
accidental experience to hold them, to incline him 
to see indications for these favorites where such 
indications do not exist. 

You will sometimes hear an experienced prac- 
titioner speak of such or such a remedy as " a 
favorite" of his. To say the least, this is a danger- 
ous way of regarding any drug. If it lead him to 
give it where a strictly impartial judgment would 
not pronounce it more exactly homoeopathic to the 
case than any other known drug, it prevents his 
curing his patient in the quickest and surest way. 
Science has no partialities, and knows no prefer- 
ences. Among the servants whom she puts at our 
disposal there is no possible position of honor for 



CYCLAMEN EUROPIUM. 



81 



one above another. The drug which cures but a 
single case a year for us, because but one case in 
the year has demanded its administration, is as 
much entitled to our scientific regard as that which 
serves us every day. 

Again, you should remember that your duty 
is, as scientific men, to judge impartially between 
the remedies which seem to be indicated in the 
case before you, and to choose, without fear or 
favor, that which is most homoeopathic to it : with- 
out fear that because it is a remedy you have sel- 
dom used it may not act so well as the symptoms 
promise ; without favor from an inclination to a 
drug that has often done good in many cases, and 
from which therefore you incline to hope for good, 
although it is not so homoeopathic to the case in 
hand. This impartial judgment is very difficult 
but all-important. You will often find yourselves 
tempted to twist the patient's symptoms, ignoring 
some and perverting others, so as to bring the 
complex into a better resemblance to those of 
some drug from which you have often seen rapid 
beneficial action. It would relieve your mind so 
greatly if it would only turn out that the simile 
of the case is really to be found in Belladonna, or 
Bryonia, or Cimicifuga ! And so you try to con- 
strue the symptoms in the direction of these drugs. 
Gentlemen, this is a delusion and a snare. If you 
thus deceive yourselves, and then give a drug 
which is not really indicated, you will get a little 
deceitful ease of mind for a few hours but no 

II — 7 



82 



CYCLAMEN EUROP/EUM. 



good to your patient. In these, as in all cases in 
life, look the truth right in the face, meet it 
squarely, and "do your level best!" You will 
find, perhaps, that not Belladonna nor Bryonia nor 
Cimicifuga is indicated, but Silicea clearly, and 
nothing else. Now you get uneasy. What ! Silicea 
a remedy for chronic diseases, for ulcers and 
abscesses — a drug of slow action ! Can I dare to 
give it in this rapid-running and, if not arrested, 
speedily fatal phlegmasia, even though it be well 
indicated? Yes, give it, nothing doubting; and 
it will henceforth rank high in your esteem. It 
is my opinion that drugs which cure in chronic 
diseases appear to be slow of action because the 
morbid processes in such diseases are slow, and 
vice versa. In other words, I believe that the 
duration of action of a drug depends not so much 
on some inherent positive quality of the drug as 
upon the rapidity with which the physiological 
(and hence the pathological) processes are accom- 
plished in the tissues involved and acted upon, 
which are slow in chronic, and rapid in acute, dis- 
eases. We shall have occasion to recur to this 
subject. 

The value of Pulsatilla in measles having been 
mentioned, this is a suitable time to speak of 
another drug which, in its applicability to this same 
form of disease, is closely related to Pulsatilla ; I 
mean the Euphrasia officinalis. 

Moreover, the eminent value of Pulsatilla in 
certain forms of anaemia and amenorrhcea, makes 



CYCLAMEN EUROPiEUM. 



83 



this a proper place to treat of the Cyclamen 
Europaeum, which is near akin to Pulsatilla in its 
physiological effects. 

An immediate comparison of these drugs with 
their cognate, Pulsatilla, may bring sharply and 
clearly before your minds the resemblances and 
differences which constitute the elements of our 
decision in selecting or rejecting the remedy for a 
patient. 

I shall proceed to treat of three drugs which, 
one in one point and others in other points, are 
related to Pulsatilla (but none of which is so well 
proved or so frequently called for in practice 
as that polychrest), — Cyclamen, Euphrasia and 
Allium cepa. 

The Cyclamen Europseum, or Sow-bread, 
although no longer contained in the pharmaco- 
poeia of the allopaths, was extensively used in 
medicine by the ancients. Their descriptions of its 
properties are vague enough, but it is remarkable 
that they ascribe to it a power to affect the uterus 
and its appendages — which ascription was not 
physiologically verified until the most recent prov- 
ings, which were made by members of the Aus- 
trian society of homoeopathic physicians at Vienna. 
(Vol. ii.) 

It used to be considered that the root of Cycla- 
men, applied externally, hastened difficult labors, and 
assuaged the pains. Also, that to touch Cyclamen, 
or take it internally, would produce abortion, or 
bring on premature labor. In less ancient times it 



8 4 



CYCLAMEN EUROPvEUM. 



was used as a remedy for amenorrhcea, and likewise 
to promote die expulsion of die placenta. 

Our knowledge of the physiological action of 
Cyclamen is probably quite incomplete. I can 
offer no complete analysis of its effects. It was 
proved by Hahnemann and his pupils (Materia 
Medica Pura, vol. v.), and again by the Vienna 
society (Zeitschrift des Vereins, etc., vol. ii.). 



SPECIAL ANALYSIS. 

Sensorium. The sensorium is benumbed, the 
mind becomes inactive ; lassitude and drowsiness 
oppress the prover, and yet he does not sleep inor- 
dinately. The memory is somewhat impaired ; 
there is no disposition to mental labor. Cyclamen 
produces dizziness, which is perceived when one is 
standing still, and even when leaning the head 
against a support. It seems as if the brain were 
moving within the cranium, or as it does when 
one is riding in a wagon with the eyes closed. 
Objects move in a circle, or oscillate before the 
eyes. It is worse toward evening,, and even is 
troublesome in bed, feeling as if the head were 
revolving. It is worse when one walks in the 
open air, is better in the room and when sitting. 

Note the resemblances to Pulsatilla and the 
differences. The vertigo is worse in the afternoon 
and evening, as are Pulsatilla symptoms generally. 
But it is worse in the air and when in motion, 
and better '"\ the room and when sitting quietly ; 



CYCLAMEN EUROPIUM. 



85 



just the reverse of Pulsatilla in both of these con- 
ditions — air and motion. Confusion of the head 
and depressed feeling. Despondency, with irritation. 

Head. The pains in the head are chiefly of a 
drawing, sticking or pressing character. Some- 
times they pass from one side to the other, some- 
times from the front to the back part of the head, 
but this is rare. They are located chiefly in the 
front part of the head, a stitching headache in the 
left temple being a strongly marked symptom. 
The semi- lateral character of the headache is 
marked, it occupies one side of the head or the 
other, the left temple being the, seat of the pdn 
almost always. In this Cyclamen resembles Spi- 
gelia, but the Spigelia pains involve the globe of 
the eye. Ignatia, Thuja and Silicea, among others, 
have semi-lateral headaches. 

The pain is worse in the afternoon and evening. 
It is accompanied, when severe, by dimness of 
vision, or almost complete obscuration of sight ; it 
is also accompanied by a sense of heat in the 
head, and this and the pain are relieved by the 
application of cold water. 

The obscuration of vision accompanying the 
headache, when considered in connection with the 
pale complexion, rings about the eyes, depraved 
appetite and enfeebled digestion, and menstrual 
irregularities of Cyclamen, appears to be only a 
functional disturbance ; but it is one which points 
to its use in certain forms of anaemia in women. 

Eyes. The eyes look dull, lie deep, and have 
blue rings around them. The pupils contract and 



86 



CYCLAMEN EUROPIUM. 



dilate alternately every few seconds. Dilatation is 
the more permanent condition. Glittering, as of a 
multitude of needles before the eyes. Obscured 
vision in all degrees, from the semblance of a cloud 
before the eyes to absolute (though transient) 
blindness. " It grows black before the eyes." 
Where there appears no obscuration, the strength 
of vision seems to be impaired. 

It remains for clinical experience to show us 
the full significance of these symptoms and what 
relation they bear to diseases of the eyes attended 
by histological changes.* 

Ears. Roaring and noises especially at night 
Earache with the headache. 

Nose. The sense cf smell is blunted. Sneez- 
ing and profuse coryza. Frequent and forcible 
sneezing, with itching in the ear. Frequent but 
not copious epistaxis. 

Face. The face is pale, but the cheeks are the 
seat of circumscribed redness and heat. Eruption 
on the face; many papules which often become 
filled with yellowish-white serum and then dry up ; 
the y are more abundant on the forehead. 

Mouth. Much tenacious mucus in the mouth. 
Fauces red. Increased salivation. The diminution 



* The sense of vision seems 
to be markedly modified, the 
pup/Is being greatly dilated, and 
the sight obscured even to abso- 
lute blindness ; but it is to be 
noticed that these symptoms 
always accompany the symptoms 



of gastric disturbance and the 
headache, and they are unques- 
tionably sympathetic with these 
affections, and are not idiopathic 
eye symptoms. [Taken from 
another paper on Cyclamen. — 
H. E. K. D.] 



CYCLAMEN EUROPIUM. 



87 



of the sense of taste in Cyclamen probably is 
closely related to the alteration of the mucous 
secretions of the buccal surface. Natrum muriati- 
cum has complete loss of taste without such altera- 
tion, but coinciding with coryza. This coincidence 
is characteristic of it. 

Tongue covered with a white coat, red at the 
tip, with several small vesicles which burn when 
she speaks or chews ; salivation being abundant. 

Taste. Pappy taste. The sense of taste is 
blunted; almost all food tastes alike (or is alike 
tasteless); nausea and bitter taste. The white - 
coated tongue, flat, pappy taste, aversion to fat 
and to bread and butter, remind us strongly of 
Pulsatilla. But the aversion to food after eating 
but little (although the first mouthful were enjoyed) 
and the great thirst, are different from the Pulsa- 
tilla symptoms. 

Appetilc. Diminished. Or good appetite, but 
one becomes satisfied after eating but little. Sud- 
den satiety. Aversion to various articles of food, 
to bread and butter, to fat, and to meat. Great 
thirst ; increased, even excessive thirst. Little or 
no thirst. 

Stomach. The digestion is weakened ; yet there 
is little or no change in the organic substance, 
although we might infer that a tendency to a 
change in the blood composition, similar to that 
in chlorosis, might result from a more thorough 
proving. Eructations of a fatty taste and smell ; 
nausea, and accumulation of water in the mouth ; 



88 CYCLAMEN EUROIVEUM. 

eructations tasting of the food last eaten. Nausea, 
with headache, vertigo, seeing of colors and double 
vision. The nausea is relieved by lemonade, as is 
also that of Pulsatilla, from fat food, especially 
pork. Oppression, as from too copious a meal. 
All of these symptoms are worse in the evening. 
Pressure and distention in the region of the stom- 
ach. Vomiting of mucus, after which sleep. There 
is much qualmishness and semi-nausea, as after eat- 
ing fat food, with chilliness and depression of spirits. 

Hypochondria. Stitches in the liver, and stitch- 
ing pain in the intestines below the liver. 

Abdomen. Fullness in the abdomen, distention 
by much flatus. Rumbling, with pain and nausea. 
The hypogastrium is very tender to pressure. 

Stool. Much disposition to stool, renewed even 
after evacuation. While the rectum symptoms, 
tenesmus, etc., resemble those of Pulsatilla, the 
stool differs. 

Stool first normal, then liquid, light yellow. 
Evacuation forcible, as if shot out. Diarrhoea 
yellow, pappy or watery, preceded by pinching 
pain in the abdomen. Pressure upon the rectum 
and anus, with itching, burning, and discharge of 
blood. Diarrhoea renewed by coffee. 

Urinary Organs. Frequent copious discharge 
of whitish urine, stitching in the urethra, and dark- 
red urine. Scanty urine. 

Sexual Organs. Men. Glans and prepuce sore. 

Women. Menses too profuse and too frequent, 
with severe labor-like pains. Discharge clotted, 



CYCLAMEN EUROP/EUM. 



8 9 



and black, and membranous. Cyclamen differs 
entirely from Pulsatilla. Instead of being scanty 
and retarded, the menses are too profuse and 
anticipate, while at the same time many constitu- 
tional symptoms are the same as those of Pulsatilla. 

In the mammae, a watery secretion, resembling 
milk, which leaves on the linen spots like a weak 
solution of starch. It flows spontaneously and can 
be pressed from the breast. This discharge fol- 
lowed and relieved a sense of fullness and tension 
and stitching in the mammae, which were larger 
than natural, and felt as if a stream of air from 
the stomach and abdomen had been passing out 
through the nipples. 

Thorax. Dyspnoea, oppression. Great lassitude ; 
feeling as if she had not strength enough to draw 
a full breath. Pressure on the sternum. Stitches 
here and there in the chest. Palpitation of the 
heart. Irritated heart action. Pulse at first accel- 
erated and double, then quiet and very weak. 

Back. Drawing down the spine. 

In the right side, in the region of the kidney, 
a deep pinching dull stitch, recurring every few 
seconds, worse on inspiration, which indeed is 
almost prevented by the violence of the pain. 

In the glutseus maximus (left) rheumatic draw- 
ing extending to the sacrum. Drawing in the 
sacrum. Stiff neck. Tearing over the scapula, with 
paralyzed feeling in the arm. 

Upper Extremities. Paralytic hard pressure, 
feeling as if it were in the periosteum and deep 



QO CYCLAMEN EUROR/EUM. 

in the muscles, extending into the fingers and pre- 
venting writing. Painful drawing in the inner sur- 
faces of the elbow and the wrist. Spasmodic, slow 
contraction of the thumb and index ; it needs force 
to extend them again. Pricking itching as from 
needles between the fingers, relieved by scratching. 
Numbness in the right hand. 

Lower Extremities. Cramp-like pain in the 
thio-hs. Numbness. Soreness of the heels and 
toes. 



GENERAL ANALYSIS. 



As regards functional activities, Cyclamen de- 
presses the sensorium, as we have seen, producing 
confusion, vertigo, lassitude. Vision is enfeebled, 
and, for the time, under certain circumstances, sus- 
pended. Digestion is retarded and enfeebled, the 
taste blunted, appetite soon and suddenly satiated, 
desires for food unnatural and restricted, thirst 
increased. The activity of the large intestine and 
of the female sexual system seems to be increased, 
diarrhcea and menorrhao-ia resulting. The organic 
substance is modified in so far as that diarrhcea is 
produced, the menstrual flow is increased, hastened, 
and changed to a dark, lumpy mass. The skin, 
too, is the seat of a vesicular or pustular eruption, 
itching, but relieved by scratching — this chiefly in 
the face. The scalp itches, the itching ceases on 
scratching,* but immediately recurs in another place; 
the itching- [ s a fi ne stitching or biting sensation. 



CYCLAMEN EUROPIUM. 



91 



The fever, in so far as fever is produced by 
Cyclamen, is partial in all its stages. Chill pre- 
dominates. The heat occurs at evening, and is 
without thirst. 

Sleep is restless. It is hard to fall asleep in 
the evening. One goes to sleep late, has vivid 
dreams, wakens early, before day-break, but is very 
tired ; lies awake, cannot sleep again, yet even at the 
usual hour for rising cannot get up because of lassi- 
tude and weakness. The pains, which ceased during 
sleep, re-appear soon after waking. This is different 
from the sleep of Pulsatilla, which begins late but 
is sound, and the patient sleeps till late in the 
morning. It is different from Nux vomica, which 
has early evening sleep. Sulphur has no sound sleep. 

The peculiarities of Cyclamen are found in the 
fact that so many of the symptoms of various parts 
of the body, as for example the digestive and the 
female sexual organs, are accompanied by the 
semi-lateral headache (in the left temple) with 
nausea, vertigo and obscuration of sight, the face 
being pale and the eyes sunken. 

The aggravations are at night and when at 
rest ; from eating fat food, and while reposing. 
Ameliorations when moving. 

If, now, we compare this record, scanty as it 
is, with the symptomatology of Pulsatilla, we are 
struck with the resemblance. The gastric symp- 
toms are almost identical. 

We have the same white-coated tongue, the 
same qualmishness and disgust for food, especially 



9 2 



CYCLAMEN EUROPIUM. 



fat food, the same absence of thirst and of febrile 
excitement, the same sympathy of the sensorium, 
eyes and head with these gastric symptoms. The 
peculiarities of the affections of the head and eyes 
are different, to be sure, from those of Pulsatilla ; 
for Cyclamen produces semi-lateral headaches and 
absolute blindness, while the blindness of Pulsatilla 
is incomplete and only momentary, and the head- 
ache equi-lateral. But this very difference is a 
matter of congratulation, for there is a prospect 
that one or the other will cover most of the cases 
of sick headache and megrim that come before us 
for treatment. 

But a large majority of such cases are the 
concomitants, if not the consequences, of menstrual 
irregularities, chiefly amenorrhcea, for they gener- 
ally occur in women. 

Now, you will have taken notice that in giving 
a summary of the action of Cyclamen just now, I 
said nothing whatever of its effects on the sexual 
organs of women. 

What a pity, one cannot help exclaiming, that 
it does not act on these organs and affect their 
functions, for if it did, there could hardly be im- 
agined a more admirably homoeopathic remedy for 
the megrim that attends irregular menstruation. 
Failing such action, we might hardly be warranted 
in giving it. But does it not act on these organs 
and modify these functions ? Hahnemann did not 
know that it did nor did his pupils. How could 
any one know ? Only by the drug being proved 
by women on themselves ! 



CYCLAMEN EUROP/EUM. 



93 



No other form of proving, no other mode of 
investigation could give us this desired knowledge. 

Not, therefore, until under the auspices of the 
Vienna Society, very imperfect provings were made 
by women, had we a knowledge of the fact that 
Cyclamen does indeed cause scanty menstruation, 
indeed cause absolute amenorrhcea, with megrim 
and loss of vision. 

The only clinical indications for Cyclamen that 
I shall draw your attention to just now, follow 
directly from what has been said. 

It promises to be, and has approved itself, a 
remedy of great value in those forms of menstrual 
irregularity which are attended by megrim and 
blindness. 

In gastric disorders, the symptoms of which 
resemble those already described, and for which 
Pulsatilla seems to be the suitable remedy, but 
where the headache is semi-lateral rather than gen- 
eral, Cyclamen is likely to be of service. 

The remarks which have been made on the 
subject of our knowledge of the action of Cycla- 
men on the organism of women, lead directly to a 
subject of exceeding importance to all women who, 
in studying the profession of medicine, aim to be 
not merely apprentices to an art by the exercise 
of which they can make a living, but also, and 
more than this, students of a science fraught with 
blessings to the race, a portion of eternal truth, a 
science which it is the mission of the human race 
to elaborate and make perfect, — each student doing 
his or her appropriate work, and having a place 



g4 CYCLAMEN EUROIVEUM. 

to fill and a function to perform, indispensable to 
the perfection of the task. 

Is it the ambition of any one of you to study 
science in this spirit ? Will you work for a living, 
then die, and leave no sign ? Or do you aim so 
to order your professional career that, while you 
gain an honorable livelihood by honorable toil, you 
may yet, when you pass away, leave science the 
richer for some facts or some generalization ; 
adorned by some memorial of a life honorable to 
your art, which is eternal, as well as to your own 
ephemeral personality ? 

At the same time that you, in common with 
all students, may cherish this honorable ambition, 
do you more particularly, as women, desire to vin- 
dicate your enterprise in exploring the paths of 
medical science hitherto untrodden by your sex? 
Are you willing to enter upon a path of scientific 
investigation and research which the feet of man 
. can never tread, the results of which, while they 
splendidly justify you in entering on the study of 
medicine, shall confer blessings unspeakable on 
that half of the race which is of your own sex, 
and thus on the whole race ? 

To those who are thus minded, to those women 
who can do for women what men have done for 
men, and would have done for women had it been 
within their power, I will indicate the way of self- 
sacrifice which ends in honor. 

All the facts stated in these lectures concerning 
the action of drugs on the human organism have 



CYCLAMEN EU ROPvEUM. 



95 



been derived from provings of drugs on the 
healthy subject. Although those provings have 
been extensively and accurately made only by 
homceopathicians, yet their necessity is urged and 
admitted by the leading authorities of every school 
of medicine. 

The principle is this : We learn how a drug 
affects the healthy organism, and from this action 
we judge, according to a law of cure, what effect 
it would have upon a sick person. 

Now, we have seen that drugs act differently 
upon different living organisms. We may not infer 
from the action of drugs upon animals their action 
upon man, because the organs of animals differ 
from those of man. Neither, then, may we infer 
from the action of drugs upon men their action 
upon women ; more particularly as regards the 
action upon those organs which distinguish women 
from men. 

Here, then, I find a worthy and an indispensable 
work for women who are educated physicians, as 
worthy and no less indispensable than that of men. 

Claim, if you please, for women an equal right 
with men to practice medicine and make money, I 
admit their right and would give them fair play, 
but I do not see any necessity, except it reside in 
their own desires and impulses. But as regards 
the work of perfecting the sciences of physiology 
and pathology and materia medica, I see so great 
a necessity for women to devote themselves to the 
labors of investigation and experiment, that I 



g6 cyclamen europium. 

should never cease to urge on them such a devo- 
tion of their gifts and of themselves, for the sake 
of science and of their own fellow-women whom 
this devotion would make science so much more 
potent to relieve ! 

I care not so much to shield women from what 
is called the rude attendance of rough men in the 
sick-room ; but I do desire that women should 
prove drugs and ascertain their effects on the 
healthy, and what sicknesses they will cure, so that 
the medical attendant on sick women, whether he 
be man-doctor or woman-doctor, may know what 
druo- to eive and how to cure ! 

This is a mission which none but medically 
educated women can fulfill. 

The students of our colleges and hospitals are 
all engaged, and are wont to engage, in drug 
provings. Will you do as much for your sex as 
men do for theirs? Will you engage in proving 
druo-s ? The mouths of those who rail against 
women's medical colleges would be effectually 
closed could we place in their hands an exhaustive 
proving by women of such a drug as Murex, or 
Cyclamen, or Caulophyllum ! 

The problem in drug proving is simply to 
ascertain the specific individual effects of the drug 
upon the healthy organism of the prover. 

In order to get only the specific effects, uncom- 
plicated with the generic effects, the prover must 
begin with very small doses, until the measure of 
his or her susceptibility has been gauged. 



CYCLAMEN EUROP/EUM. 



97 



In order to be sure that the symptoms noted 
are in reality the effects of the drug experimented 
on, the prover must be always on the watch to 
discriminate between such effects and sensations to 
which he or she may be constitutionally subject ; 
or the effects of unusual exertions, of changes in 
diet, of exposure to physical, mental or moral 
excitement or depression. 

The symptoms of mind and disposition should 
be carefully noted. 

The conditions of symptoms, viz. : the times 
and circumstances when and under which symp- 
toms are aggravated or ameliorated should be 
most carefully noted. 

Also the relations of symptoms to each other. 

Inasmuch as changes in different organs in the 
body occur with very different degrees of rapidity, 
the prover should not hastily repeat doses, nor 
change the drug he is proving, nor relax the vigi- 
lance of his self scrutiny. For, though symptoms 
of the mind, or stomach, or lungs, may occur very 
soon after taking a dose of the drug, on the other 
hand, symptoms of the skin, bones and glands, 
may not occur for weeks or months. 

I should recommend the proving of Murex 
purpurea as a drug that promises to be very use- 
ful, and would advise the provers to begin with 
the sixth dilution, taking a three-drop dose every 
night for four nights, and then awaiting results for 
a week. The class of provers may report progress 
every week. 
II.— 8 



EUPHRASIA OFFICINALIS. 



EYEBRIGHT. 

EUPHRASIA officinalis, or " Eyebright," is an 
annual, belonging to the family Scrophulariacece. 
It is common in northern Europe and in England, 
and is found in the northern United States. The 
Latin, as well as the English name, shows this 
plant to have had popularly ascribed to it healing 
virtues in diseases of the eye. Milton and Shen- 
stone both speak of it as a well-known eye 
remedy. Since the year noo A. D. it has been 
mentioned as such in medical works. But, within 
fifty years, since it has become the fashion to ignore 
the specific properties of drugs, and to base pre- 
scriptions directly upon physiological and patholog- 
ical hypotheses and the generic action of drugs, 
Euphrasia has been utterly neglected. Now, we 
may be sure that no substance ever gains, and for 
centuries maintains, over a whole continent, a high 
reputation for power to cure diseases of any organ, 
without there being something of solid foundation 
in fact for this reputation, whatever errors in 
degree, whatever absurdities in hypothetical expla- 



EUPHRASIA OFFICINALIS. 



99 



nation, may have grown up around this fact, and 
obscured and disfigured it. Hahnemann says that 
''it was not without reason that this plant received 
the name it bears," and that "it has fallen into 
unmerited disuse in the present day." 

The same may be said of our own day. You 
will hardly hear of Euphrasia at the Eye Infirmary 
or at the hospitals, and yet you will there hear of 
no single remedy that will promptly and completely 
cure so many cases of catarrhal ophthalmia and of 
keratitis as Euphrasia will. 

Our knowledge of the physiological properties 
of Euphrasia is derived from a proving of Hahne- 
mann and his pupils, and one by the Austrian 
Provers' Society (Zeitschrift des Verein, 1857). 
These provings are not very complete, or if com- 
plete they show that Euphrasia does not embrace 
in its sphere of action the whole circuit of the 
organs of the body. I shall speak chiefly of the 
symptoms produced by it on the eyes and the 
respiratory organs. 

The eyes appear to be affected in almost every 
part ; eminently, however, the conjunctiva, the 
cornea, the lachrymal gland and sac, and the 
special sense. (Whether or not the retina be 
organically affected we cannot say positively, from 
absence of physical inspection.) 

The conjunctiva is reddened, the vessels en- 
larged, the mucous secretion at first diminished but 
speedily increased, and so modified as to become 
semi-purulent in character. 



IOO 



EUPHRASIA OFFICINALIS. 



As necessary concomitants of these physical 
conditions occur the following subjective symptoms': 
A sensation as if dust or sand were in the eyes ; 
pressure and tension of the globe ; sudden and 
momentary obscuration of vision, relieved by wink- 
ing, and evidently caused by the presence of opaque 
mucus upon the surface of the cornea ; and noc- 
turnal or rather morning agglutination of the lids. 
The secretion of tears is wonderfully increased in 
quantity, the eyes are constantly suffused ; the 
lachrymal duct does not suffice to carry away this 
excessive secretion (perhaps its calibre is dimin- 
ished through turgidity of its lining membrane), 
and the tears overflow upon the face and run 
down the cheek. 

The secretion of tears is not only increased in 
quantity ; it is altered in character. The tears are 
very acrid, excoriating the lids, which swell and 
ulcerate on their margins, and causing inflamma- 
tion and even suppuration of that part of the cheek 
which is kept wet by them. 

It might be inferred from our knowledge of the 
natural history and course of ophthalmic disease, 
that where the globe of the eye is kept bathed in 
muco-purulent secretion and with acrid tears, as is 
the case under the action of Euphrasia, softening 
and ulceration of the cornea would speedily take 
place. We see this in cases of purulent ophthalmia, 
especially of a specific character ; and we see it in 
cases where this condition of the eye is provoked, 
promoted or fostered by the constant injudicious 



EUPHRASIA OFFICINALIS. 



IOI 



application of hot fomentations and poultices to the 
eye. 

From these facts it is a legitimate function of 
pathology which leads us to infer that the proving 
of Euphrasia would, if pushed further, develop 
ulcers of the cornea. 

Acting upon such an inference, or else guided 
only by the other symptoms of the case, homoe- 
opathic physicians early gave Euphrasia in cases 
of ulceration of the cornea ; and the clinical record 
of its application is long and brilliant. It has been 
very successfully used in ulcers, both superficial 
and deep ; and for the removal of obscurations and 
opacities of all grades. 

Ulceration of the cornea is found also in cases 
not marked by the conjunctivitis and profuse dis- 
charges here described — cases of keratitis, or, as 
it was formerly called, scrofulous ophthalmia. The 
conjunctiva is even unnaturally bloodless, and the 
globe of the eye has a pearly aspect. The palpe- 
bral conjunctiva alone may be congested, striated, 
or studded with granulations. In such cases, when 
the photophobia is excessive, Conium maculatum 
is a remedy of exceeding value. It will, where 
indicated, be found to cover the symptoms of the 
depraved nutrition and innervation of the patient. 

In other cases the lids are swollen and the 
secretions more abundant than where Conium is 
indicated, and the photophobia excessive in the 
morning- and forenoon, so that the child buries its 
head in the pillow, while in the afternoon it will 



102 



EUPHRASIA OFFICINALIS. 



use the eyes freely. In such cases, the general 
symptoms of the digestive tract and of the sleep 
almost always indicate Nux vomica, which cures 
the eyes as well, and very speedily. 

As regards the special sense it is both exalted 
— photophobia resulting in a very marked degree, 
the patient being unable to endure the light— 
and it is perverted. The patient becomes very 
near-sighted. Again, the prover dreams of fire, 
lightning, flames, etc. Such dreams, if frequently 
repeated, are regarded as indications of deep-seated 
disease of the eye. 

The nasal mucous membrane is affected much 
as the conjunctiva is. It is swollen, and secretes 
an abundance of water, and, later, of a muco- 
purulent substance, with sneezing and some degree 
of dyspnoea. 

It is noteworthy that whereas the discharge 
from the eyes is acrid, excoriating the lids and 
cheek, that from the nose is bland, not excoriating 
the alae nasi and lip. 

Exactly the reverse is true of the discharges 
produced by Allium cepa from the eye and nose 
respectively. The tears are bland while the nasal 
discharge is acrid. This difference often serves to 
distinguish the indications of the two remedies. 

The mucous membrane of the throat and bron- 
chi is similarly affected. There is abundant mucous 
secretion, a loose cough, and a loud bronchial rale. 

One prover speaks of a "red rash" upon the 
face, produced by Euphrasia. 



EUPHRASIA OFFICINALIS. 



IO3 



The fever is not of a high grade. Chilliness 
predominates. 

Among the clinical indications for Euphrasia I 
mention first, catarrhal ophthalmia ; in fact, any 
inflammatory state of the eye which is characterized 
by congestion of the conjunctiva, or great photopho- 
bia conjoined with excessive lachrymation, the tears 
being acrid. Beside helping in these cases, it often 
removes chronic opacities ; and it is said to have 
cured several cases of cataract. It is my belief that 
these chronic cases, which Euphrasia cured, once 
presented (viz., in their acute stage) the symptoms 
above described as indicating Euphrasia. And this 
statement of my belief induces me to call your 
attention to a mode of prescribing for certain 
chronic conditions which present no symptoms 
whatever to indicate a remedy. The method is to 
prescribe for the acute malady in which these 
chronic conditions originated. It can only be done 
when we can get a clear and trustworthy picture 
of the acute affection as it once really existed. As 
a striking illustration of this method of selecting a 
remedy, I venture to refer to a cure of deafness,* 
reported by myself in the " American Homoeopathic 
Review," vol. i., and which I may add was a per- 
manent cure. (1868.) 

Certain cases of measles present chiefly eye- 
symptoms, and these of such a character as to 
call to mind the symptoms of Euphrasia. Con- 



* Deafness cured by Mezereum. See " Homoeopathy the Science 
of Therapeutics," page 462. 



104 EUPHRASIA OFFICINALIS. 

joined with eye-symptoms are more or less of nasal 
and bronchial catarrh, and these symptoms find 
their analogues in Euphrasia. 

As a matter of fact no less than of inference, 
Euphrasia is a remedy of prime importance in 
measles whenever the eye-symptoms are strongly 
pronounced as well as in ophthalmia, and is a valu- 
able remedy in simple nasal and bronchial catarrh. 



ALLIUM CEPA. 



THE COMMON RED ONION. 

WHY should not this peculiar and pungent 
vegetable, which contains notably phos- 
phorus and sulphur, and of which the juice, even 
in the form of vapor, acts so promptly and so per- 
suasively upon the conjunctiva and the Schneiderian 
membrane — why should it not produce physio- 
logical symptoms, and prove useful as a remedy ? 

Dr. C. Hering, of Philadelphia, to whom our 
materia medica owes so much of matter ' and of 
light, published a proving of Cepa in his "Ameri- 
kanische Arzneipriifungen, 1857." The symptoma- 
tology is preceded by a most interesting resume of 
the history of Cepa. I propose to give a summary 
only of the action of Cepa upon the conjunctiva and 
the respiratory mucous membrane. 

Biting and burning in the eyes with abundant 
secretion of tears ; the eyes are constantly suffused 
with them. The burning is particularly felt in the 
margins of the lids. The tears are bland, not acrid, 
and do not scald the lid or cheek. 



io6 



ALLIUM CEPA. 



Under Euphrasia, on the contrary, the tears are 
acrid, while the nasal discharge is bland. 

Coryza. Discharge from the nose watery ; it 
drops from the tip of the nose. There is much 
sneezing, especially in coming into a warm room. 
It is worse in the evening. 

Arsenic has sneezing in the cool air, after leav- 
ing a warm room ; and its coryza is not attended 
by the laryngeal symptoms of Cepa. The coryza 
of Natrum muriaticum is characterized by entire 
loss of taste. 

The nasal discharge of Cepa is very acrid, 
excoriating the upper lip, which becomes red and 
very sensitive. 

Mercurius produces an acrid nasal discharge, 
but it is not so limpid, does not drop, and it 
excoriates the alse nasi and columna, rather than 
the lip. 

Along with this coryza there are roughness and 
rawness of the fauces and of the trachea. There 
is cough, dry and hoarse, or rough, provoked by a 
tickling in the larynx behind the pomum Adami. 
It is characteristic of Cepa that when in obedience 
to this tickling provocation the patient coughs, 
there results an extremely painful, splitting sensa- 
tion in the larynx, as though that apparatus would 
be rent asunder by the effort of coughing. This 
pain makes the patient wince and crouch, and 
brings tears to the eyes. No other drug produces 
this splitting in the larynx from cough in conjunc- 
tion with acrid coryza. 



ALLIUM CEPA. 



The trachea feels rough and raw, and there is 
some dyspnoea, together with feverish heat and 
some acceleration of the pulse. 

Prescribing in accordance with the above indica- 
tions, I once succeeded in removing in the space 
of a few hours what I judged from physical 
exploration to be an extensive very recent conges- 
tion of the lungs, resulting from exposure to a 
cold north-west wind immediately after prolonged 
and violent muscular exertion. 



MATRICARIA CHAMOMILLA. 



^T^HE name of this medicinal plant is derived 
X from matrix, because of the specific action 
supposed by the ancients to be exerted by it on 
the uterus. 

It was used by the ancients, by whom likewise 
and for similar reason the name Parthenion was 
given to it. 

Culpeper says of it: "Venus commands this 
herb, and has commended it to succour her sisters; 
and to be a general strengthener of wombs ; and 
to remedy such infirmities as a careless midwife 
has there caused." 

It is found in most parts of Europe, in corn- 
fields, waste grounds and by road-sides. 

In medicine the whole plant is used; it is gathered 
when in flower, and the tincture is formed by express- 
ing the juice of the whole plant, gathered fresh, 
and mixing it with twenty parts of alcohol. 

By allopathic physicians the Anthemis nobilis 
has been substituted for the Matricaria chamomilla, 
their properties being assumed to be identical. 



MATRICARIA CHAMOMILLA. 109 

It is classed among the stimulant tonics. It 
contains an essential oil and a bitter principle. Its 
action is described as both stimulant and tonic. ' 

" In substance, or in a strong infusion, it pro- 
duces a sense of warmth in the stomach, and, it 
is said, some acceleration of the pulse. It expels 
flatus, improves the digestion, does not confine the 
bowels, and is alleged even to possess emmena- 
gogue virtues. In large doses it occasionally pro- 
duces vomiting, looseness of the bowels, pain, with 
fullness of the head ; and in certain idiosyncrasies 
it is even said to produce a sort of somnolent 
intoxication, with general depression and exhaust- 
ion." — Stille, i., 557. 

Our knowledge of the positive properties of 
Chamomilla is derived from Hahnemann's proving 
(Materia Medica Pura, hi., i). This has been sin- 
gularly corroborated within a few years by a prov- 
ing conducted by Prof. Hoppe, of Basle. 

Before proceeding to an analysis of the action 
of Chamomilla, it may not be amiss to quote at 
some length from Hahnemann's introduction to the 
proving. It is full of practical wisdom. 

" This has been extensively used as a family 
medicine in complaints of all kinds, chiefly those 
that develop themselves rapidly. But physicians 
have held it too much in contempt, not consider- 
ing it as a medicine, but only as a popular remedy ; 
and allowing their patients to use it, in conjunc- 
tion with their prescriptions, in large handfuls, for 
infusions, teas, etc., and for external applications, 



I IO 



MATRICARIA CHAMOMILLA. 



while, at the same time, they were giving internal 
medicines ; as if it were always a safe and salutary 
thing, never injurious, or at least quite unim- 
portant. ***** 

"Thus we may see how far physicians have been 
blinded with regard to a plant belonging to a class 
of powerful medicines, when it was their duty to 
acquaint themselves thoroughly with its properties ; 
not only that they might themselves make a wise 
and proper use of it, but put a stop to the gen- 
eral abuse, pointing out when good effects might 
be expected from it, and, on the other hand, when 
it should be avoided. 

" But physicians have hitherto not fulfilled this 
duty ; they have rather rivaled the public in pre- 
scribing or permitting the use of this powerful 
remedy in all cases, without distinction, and in 
doses of all degrees. 

" Yet it requires a very little ray of sense to 
perceive that no medicine in the world can be 
proper for all diseases ; that each one has its circle 
of benefit strictly defined, beyond which every 
powerful medicine like Chamomilla must, of course, 
exercise injurious action in proportion to its 
energy ; and therefore to avoid quackery the phy- 
sician ought to know previously when Chamomilla 
may be useful and when prejudicial ; as also how 
to proportion the doses, that they may be neither 
too powerful nor too weak. * * * 

" In fact no medicine, however polychrest it 
may be, can be useful and salutary in a tenth part 



U VTRICARIA CHAMOMILLA. 



I I I 



of the existing diseases ; neither can this preroga- 
tive belong to Chamomilla. But, admitting what 
is impossible, let us suppose it can cure a tenth 
part of the diseases of which mankind is suscepti- 
ble, is it not clear that if it is employed universally 
it must be injurious to the other nine-tenths ? Is 
it right to purchase success in one case to the 
injury of the other nine ? What do you mean by 
injurious effects ? says the common practitioner ; I 
see none that depend on Chamomilla. Certainly, 
I reply, so long as you are ignorant of the effects 
so powerful a medicine is capable of producing in 
a healthy person, you cannot perceive it to be the 
source of the mischiefs that are caused by the 
manner in which you employ it. These evils you 
consider to belong to the disease itself, and you 
attribute them to the malignity of that disease, 
and thus you deceive yourself, while you are doing 
harm to your poor patients. 

" But cast your eye upon the mirror which I 
hold up to you ; read the catalogue of the symp- 
toms produced by Chamomilla, and then, if you 
fall back into your daily sin, if you put no limit 
to your habitual use of this plant, see how many 
among the apparent symptoms will be attributable 
to those belonging to Chamomilla, and judge of 
the distress and pain that will be caused to the 
sick by the abuse of this substance in those cases 
in which it is not suitable, and when given in 
large doses." 

It may be remarked that the use of Chamo- 



I I 2 MATRICARIA CHAMOMILLA. 

milla is not so universal now as it was when 
Hahnemann wrote ; but his observations apply with 
equal force to whatever drugs it may be the fashion 
to use in the same indiscriminate and reckless 
way. 

GENERAL ANALYSIS. 

I. On the Vital Force, the action of Chamomilla 
is shown : 

In the fact that it exalts the general suscepti- 
bility, causing pains to be felt very keenly, so that 
a pain which might be supposed to be only moder- 
ately severe is, to the patient, intolerable. The 
disposition is impatient, intolerant, restless and very 
anxious. 

In the prostration of general muscular power and 
in the lassitude, exhaustion and disposition to syn- 
cope which Chamomilla produces ; in the peculiar 
modification of circulation which constitutes the 
fever of Chamomilla. This fever presents a com- 
pound of the features above described. Though 
marked by excitement and increased sensibility, it 
is, nevertheless, not a well-developed inflammatory 
fever. The prostration is likewise represented. 
The heat is partial, confined, for example, to one 
cheek, and is conjoined with profuse sweat of the 
head. The fever does not last long, but often 
recurs. 

In the jerkings of isolated muscles, and in 
spasms. 



MATRICARIA CHAMOMILLA. II3 

In the special perversions of functions excited 
in the nerves of sensation of various parts of the 
body, and in the digestive and the urino-genital 
organs. 

2. On the Organic Substance, Chamomilla does 
not act so vigorously nor so deeply as one might 
suppose from the nervous excitement which it pro- 
duces. It acts: 

On the digestive canal, increasing and changing 
the secretions, and provoking accumulations of 
flatus. 

On the female genital organs, producing leucor- 
rhcea, increased menstruation, and uterine haemor- 
rhage. 

On the respiratory mucous membrane, increas- 
ing the secretion. 

On the skin, producing a miliary eruption on 
the cheeks, isolated papules and pustules, and an 
unhealthy disposition of the skin, so that wounds 
do not readily heal, but become very painful. 

Periodicity is in so far a property of Chamo- 
milla action, that the pains recur in the evening, 
and are much worse at night before midnight, 
becoming then intolerable. 

Peculiarity. It is a peculiarity of Chamomilla 
that the pains are aggravated by heat: it is thus 
among a minority of medicines. 

Hahnemann remarks that "a very small dose 
of Chamomilla seems to lessen very much exces- 
sive sensitiveness to pain, and the effects which 
pain produces on the mind. For this reason it 
II.— 9 



ii4 



MATRICARIA CHAMOMILLA. 



relieves many of the morbid symptoms produced 
by excessive use of coffee and of narcotic sub- 
stances ; and it is also less beneficial to those who 
remain patient and composed under their suffer- 
ings." 

SPECIAL ANALYSIS. 

Scnsoruim. Vertigo, even to falling, especially 
after eating and when talking ; or early in the 
morning on rising from the bed. Sometimes the 
vertigo is conjoined with a kind of syncope. 

The intelligence is benumbed, or blunted, and 
distracted ; not observant. In writing or talking 
the prover lets entire words and phrases drop. 

Headache is felt even during sleep. The head 
is heavy. But the most frequent pains are tearing 
and drawing, generally anterior, and almost always 
semi-lateral. The same is true of all the pains, 
they are semi-lateral. 

Eyes. The pupils contract. 

The margins of the lids feel dry, yet there is 
morning agglutination. 

Pressure, heaviness and burning in the eyes. 
The conjunctiva is often deeply injected, without 
pain. 

The special sense is somewhat affected. The 
sight is obscured, — there is a fluttering before the 
eyes. 

Ears. The tearing, which is a characteristic 
symptom of Chamomilla, is felt in the ears; some- 



MATRICARIA CHAMOMILLA. 115 

times also single stitches, especially on stooping, 
or a dull pressure. The ear seems stopped, and 
there is a buzzing or ringing in it. 

Teeth. The affection of the teeth is a very 
prominent and characteristic action of Chamomilla, 
and has been turned to great practical account. 
The toothache rages chiefly at night, is accompa- 
nied by swelling of the cheek, and generally 
comes on or is aggravated after eating and drink- 
ing, and particularly after warm drinks. The pain 
is paroxysmal, is a drawing or tearing pain, with 
stitches toward or into the ear. The toothache, 
like the headache, is semi-lateral. 

The taste is slimy, sour or bitter. 

Appetite is extinguished. Food is repulsive. 

Frequently there are sour eructations ; and it 
is noteworthy that thereby whatever pains may be 
present are aggravated. 

After eating, a sensation of fullness, nausea, and 
distention of the abdomen. 

Nausea frequently occurs ; frequently early in 
the morning. 

Vomiting occurs sometimes, of food and bile. 

Painful pressure is felt in the stomach, epigas- 
trium and hypochondria, which sometimes embar- 
rasses respiration ; the pressure extends to the 
region of the heart. (Not only applicable in gas- 
tralgia but also in certain forms of hepatitis.) 

Flatus is generated in abundance. It moves 
about with rumbling and griping and a pressure 
downward, especially toward the inguinal canal. 



n6 



MATRICARIA CHAMOMILLA. 



There are likewise intolerable pains in the 
abdomen, cutting, pinching or tearing; and particu- 
larly with a sensation as if the intestines were 
rolled up in a ball in the side of the abdomen. 

The stool is diarrhceic, semi-fluid, sometimes 
yellow, sometimes green and watery, sometimes 
only white and slimy. It occurs most frequently 
at night, and is attended with cutting pains, which 
cause one to crouch together. It produces, like- 
wise, blind and sometimes bleeding haemorrhoids. 

Chamomilla produces a yellow, acrid leucor- 
rhcea. It causes also a uterine haemorrhage, the 
blood being generally coagulated and passed with 
severe labor-like pains. 

Before the menses there is produced a cutting 
colic and drawing in the iliac region, with frequent 
pressure to pass water. 

The respiratory organs are affected chiefly in 
their mucous membrane. 

The coryza is at first dry and obstructed ; then 
the discharge is scanty and moderately acrid. 
There is hoarseness, produced by a tenacious mucus 
in the larnyx and trachea, with an almost uninter- 
rupted tickling irritation, provoking a cough. 

Along with this there is a kind of dyspnoea 
from pressure on the thorax and pressure on the 
sternum. 

The mammary gland is affected. Indurations 
and nodosities occur in it, which are painful to the 
touch, and have, besides, a tearing and burning pain. 

In the symptoms of the trunk we find again 



MATRICARIA CHAMOMILLA. 



117 



the tearing and drawing pains of Chamomilla, 
worse at night. 

From the lumbo- sacral region such pains extend 
into the thighs, like a kind of labor-pains (hence 
its use for after-pains). 

Similar pains in the extremities, drawing and 
tearing, most violent at night, and seeming to 
have their seat in the ligaments and periosteum. 
They often extend from shoulder to finger, or from 
elbow to hand (and similarly in the lower extrem- 
ity), and are conjoined with a paralyzed or numb 
sensation. The arms often go to sleep ; there is a 
great disposition to cramps in the calves and in 
the toes. 

The hands and feet become cold and stiff ; and 
also at night the feet lose power, so that when 
attempting to stand the limbs give way. 

Sleep. During the day there is great sleepi- 
ness with yawning, but at night sleeplessness with 
anxiety, inability to remain in bed, with prattling 
delirium. 

Starting in sleep, weeping and complaints. Pain 
seems to be felt during the sleep. 

Fever. The fever is partial in all its stages. 
The heat predominates. The chill is not always 
marked by external (objective) coldness ; is attended 
by nausea, restlessness and tossing; often by burning 
heat of the head, or generally with internal dry 
heat. The heat is attended by thirst and dry tongue. 

Sweat is partial, chiefly at night, generally on 
the upper part of the body. 



n8 



MATRICARIA CHAMOMILLA. 



The disposition is anxious, restless, impatient, 
intolerant of pain. There is easy starting, as if 
affrighted ; easy vexing ; irritability ; disposition to 
anger ; great sensibility to smells ; and intolerance 
of music. 

PRACTICAL APPLICATION. 

The symptoms of Chamomilla, while their pro- 
found action on the nervous system and the 
excitement they show to be produced in the circu- 
lation, would lead us to expect benefit from Cham- 
omilla in febrile affections, yet, nevertheless, show 
so little action upon the organic substance as to 
preclude the idea of relying on Chamomilla in 
parenchymatous inflammations, or in any purely 
and strictly inflammatory affection. 

The fever is eminently one of irritation, and 
an attentive comparison of its phenomena with 
those which we observe at the bedside, will show 
its similarity to fevers arising from a more or less 
permanent physical source of irritation, such as is 
supplied by dentition, or by the irritation of indi- 
gestible foreign bodies in the intestines. 

The fever is partial; the nervous system is 
highly excited, and yet the sensorium is not per- 
verted ; pains are unreasonably intolerable ; the 
patient cannot long retain one position ; heat 
aggravates the entire condition, and yet, withal, 
the muscular strength is prostrated ; twitching and 
jerkings of isolated muscles occur, and finally gen- 



MATRICARIA CHAMOMILLA. 



II 9 



eral clonic spasms come on.** This action of Cham- 
omilla has led to its extensive and successful use 
in the diseases of dentition in infants. The diar- 
rhoea which it produces is similar to that which so 
frequently accompanies dentition. 

But dentition does not always so affect children 
that Chamomilla is indicated. 

If the child be restless, irritable, wanting always 
to be carried about in the nurse's arms (muscular 
weakness), never content in one place, nor with 
anything that is done or said, one cheek red and 
hot, the other pale, with sweating head, hot mouth, 
tickling cough, green or yellow diarrhoea, with colic; 
with these, or most of these symptoms, but espe- 
cially the disposition above mentioned, then indeed 
Chamomilla is indicated. But, if the disposition be 
mild and sluggish, the child disposed to be quiet, 
the bowels flatulent, to be sure, but costive, with 
frequent tenesmus, no matter if Chamomilla be 
recommended in forty books for dentition, give 
that child Nux vomica and cure it ! 

On the other hand, the fever may be really 
inflammatory, the pulse hard and full, and the sen- 
sorium excited with wild delirium, or dull and 
oppressed. In such cases we may expect to find, 
on searching, that organic disease of some vital 
organ has set in, which must be sought and 
treated. 

Chamomilla shows its adaptation to catarrhal 
affections of the eyes, ears, gastro-intestinal and 
urino-genital mucous membranes, and to similar 



1 20 



MATRICARIA CHAMOMILLA. 



affections of the respiratory mucous membrane. 
The secretions are moderately increased and are 
somewhat acrid. 

For semi-lateral headaches, especially when they 
accompany otalgia, odontalgia or metrorrhagia, and 
when the disposition corresponds, Chamomilla is 
useful. 

There must always be intolerance of pain, 
aggravation at night* and aggravation by warmth. 
This applies to the toothache, earache, facial and 
cervical neuralgia, and to the abdominal colic, and 
distinguishes it from the symptoms of Colocynth, 
which are diminished by warmth. 

Chamomilla has been useful in bilious vomit- 
ings and in sub-acute hepatitis. 

In mucous diarrhoeas, frequent in summer, with 
abundant griping, yellow or yellow-green mucous 
stools, often produced by check of perspiration or 
crude food, it is a most valuable remedy. There 
is no great flatulence as in Colocynth, nor tenesmus. 

Its action in controlling metrorrhagia is attested 
by both allopathists and homceopathicians. 

The discharge is paroxysmal, the blood dark 
and coagulated. 

In nasal and laryngeal catarrh its indications 
have already been pointed out. 

As a remedy for after-pains Chamomilla enjoys 
considerable repute ; likewise for certain forms of 
dysmenorrhea, where pain precedes the period, 
which cevertheless is abundant when it does occur 
(which distinguishes it from Sepia), 



MATRICARIA CHAMOMILLA. 



121 



Indurations in the mammary gland, with tearing, 
drawing pains, are often relieved by Chamomilla 
when other symptoms correspond. 

In some forms of rheumatism it has done good, 
the pains being drawing and tearing, worse at 
night and from warmth, and felt in the ligaments 
and in the periosteum. 



IGNATIA AMARA. 



STRYCHNOS IGNATIA. FABA SANCTI IGNATII. 
ST. IGNATIUS' BEAN. 

THE seed of a large tree, a native of the Phil- 
ippine Islands. It contains strychnine, and in 
poisonous doses its effects are regarded as identical 
with those of Nux vomica. 

The seeds are used in medicine. They are 
bruised and triturated. 

By allopathic writers Ignatia is classed among 
the spinants, as acting exclusively upon the spinal 
cord. Containing strychnine, it is regarded as 
identical in action with Nux vomica. 

We shall see that, however great the similarity, 
there are yet great, and to us, as therapeutists, 
most valuable differences between these drugs. 
This is not the first instance in which a superficial 
use of chemistry has led to error. 

GENERAL ANALYSIS. 

Much of what was said of Nux vomica is cer- 
tainly applicable also to Ignatia. Yet it appears 



IGNATIA AMARA. 



123 



that Ignatia acts less than Nux vomica upon the 
organic substance of the body, producing appre- 
ciable changes in the tissues, and much more 
exclusively upon the vital power. 

Upon the vital power its action is not so much 
exalting or depressing, although in certain organs 
each of these varieties of action is distinguishable ; 
but rather disturbing, destroying the harmony of 
action between different portions of the organism, 
perverting the co-ordination of functions. Thus, 
where we find heat of the body, and should anti- 
cipate such a condition of the nervous system as 
would make cool air agreeable, the contrary condi- 
tion obtains ; where we should, from the fever 
existing, expect thirst, we find none, and vice 
versa. The great sensitiveness of the surface, 
instead of being aggravated by contact and by 
pressure, is relieved by it, etc., etc. 

Now, it would seem as though such results 
from provings might be fanciful, were they not 
corroborated by too many witnesses to admit of 
the idea beinof entertained. 

And yet, singular as this state of things is, it 
finds its analogy in the natural history of disease. 
For if you analyze the phenomena of hysteria, you 
will find this "perversion of the co-ordination of 
functions " to be the fundamental principle of the 
malady. And of all our remedies none so com- 
pletely corresponds to hysteria, and so often cures 
it, as Ignatia. 

In the words of Dr. Wurmb the whole cbarac- 



1 24 



IGNATIA AMARA. 



ter of Ignatia may be expressed in two words : 
" Entgegengesetzte nebenbesc hwerden" 

Accessory or concomitant phenomena which are 
contradictory to or inconsistent with each other. 

SPECIAL ANALYSIS. 

• Head, The headache of Ignatia is aggravated 
by talking or listening or paying close attention to 
anything, but not by independent mental action. 
It is a sensation of heaviness, as if congested, 
relieved by stooping and leaning forward, not 
therefore a real congestion (here is a contradic- 
tion). There is sometimes a semi-lateral throbbing, 
sometimes a throbbing over the orbits. 

The most characteristic pain is that as if a nail 
were driven into the head. It is generally in the 
parietal or vertical region. Thuja has a similar 
pain in the occiput. This calls to mind the clavus 
hystericus, in which Ignatia is very useful. 

Eyes. The affection of the conjunctiva is mod- 
erate. There is but little congestion. On the 
contrary, photophobia is sometimes intense, though 
capricious. 

The vision is affected in this way : on one side 
of the axis of vision is observed a zigzag, white 
flickering. 

Ears. Ringing and noises in the ears are 
observed. 

Face. The muscles of the face and the lips 
often twitch and are convulsed. 



IGNATIA AMARA. 



125 



Teeth. It is noted of the Ignatia toothache 
that though it consists chiefly in a soreness and 
tenderness of the teeth, it is felt more in the inter- 
val between meals than when eating. (Another 
contradiction.) 

Throat. The sore throat of Ignatia, which is 
a sticking sensation, is felt more when swallowing 
than when the throat is at rest. 

The digestive organs are much modified in 
action. The mouth is full of mucus. The taste is 
flat ; food ha:; a bitter, repulsive taste. There are 
fanciful aversions to special articles of food. There 
is sometimes craving for a particular article, and 
then, after a email portion has been taken with 
great enjoyment, a sudden and great aversion to it. 

Frequent regurgitation of food and of a bitter 
liquid. Vomiting at night of food taken in the 
evening. Empty retching relieved by eating. 
(Contradiction.) 

Distention of the abdomen after eating. Sour 
eructations. Salivation copious, frothy, sour. Hic- 
cough. 

In the region of the stomach great emptiness 
and qualmishness and weakness, with a flat taste 
in the mouth. Characteristic. 

(The above three paragraphs are very important, 
applying to vomiting in pregnancy.) 

There are sticking and soreness in the epigas- 
trium, and moderate flatus, with cutting and griping. 

The stool is but little affected. There is a 
tendency to frequent but scanty stool, as in Nux 



IGNATIA AMARA. 



vomica ; but Ignatia acts less on the substance of 
the rectum and more on its nerves. Thus in the 
rectum we have a distressing contraction and con- 
striction of the sphincter, most painful after a stool, 
and when walking and standing, and relieved by- 
sitting. (Contradiction.) 

These are very important symptoms ; violent 
stitches shooting from the rectum upward and 
forward into the abdomen. Along with these 
soreness, constriction and blind or bleeding haemor- 
rhoids, worse after a stool. 

Besides these symptoms of haemorrhoids and of 
proctalgia, itching and creeping at the anus indi- 
cate the presence of ascarides. 

The chief symptoms of the urinary system are 
an increased secretion of clear, lemon-colored urine. 
(Hysteria.) 

Menstruation is too frequent and too copious, 
and for this state of things, other symptoms cor- 
responding, Ignatia is a remedy. 

Respiratory Organs. With regard to the respi- 
ratory organs, besides the itching of the nose and 
disposition to ulceration around the anterior nares, 
I call attention only to the cough. 

This is characteristic of Ignatia. It arises from 
a feeling of constriction in the trachea or larynx, 
as if drawn together, then a tickling as if feather 
dust were in the throat ; the cough is dry, violent, 
shattering ; the shocks come in quick succession ; 
the tickling irritation is not relieved by coughing. 
On the contrary, it becomes worse the longer the 



IGNATIA AMARa. 



127 



patient coughs, and is only relieved by a resolute 
suppression of the cough. (A marked contradiction, 
this ! ) The cough occurs chiefly in the evening, 
after lying down. This cough is unlike that of 
any other drug ; the contradiction is the character- 
istic feature. 

There is occasional spasmodic dyspnoea. 

In the trunk various tearing pains, and lassitude. 

There are jerkings and twitchings in the ex- 
tremities, especially after lying down at night, and 
startings when just falling asleep. 

Sleep is sometimes deep and irresistible, some- 
times the patient is wakeful. It is disturbed by 
dreams. 

The fever is partial in all its stages. The 
peculiarity of the chill is that it is relieved by 
external heat, and that it is accompanied by exces- 
sive thirst ; whereas the fever, which is partial, is 
not attended by thirst. (Contradiction.) 

The symptoms of the mind are most important. 
Anxiety, as though something terrible had hap- 
pened ; he cannot speak because of it, Hurry, 
fearfulness, terror, alternating with irresolution and 
inertness. Fixed ideas ; the prover sits still and 
broods over thoughts and griefs. 

PRACTICAL APPLICATION. 

Ignatia is indicated : 

1. When the bad effects of anger, of grief, 
and of sudden mental shocks produce still grief, 



IGNATIA AMARA. 



or a disposition to brood over sorrow instead of 
giving way. But when these emotions and shocks 
make the patient supercilious or crazy, give Pla- 
tina ; when boisterous and wild, Belladonna. 

2. In convulsions. In epileptic attacks, with 
consciousness ; in convulsions from grief ; from den- 
tition ; from labor, when without fever or cerebral 
congestion ; not, therefore, where Hyoscyamus or 
Belladonna is required. 

3. In intermittent fever, when there is chill with 
thirst or fever without. Distinguished from Ipecac- 
uanha, Eupatorium, Rhus toxicodendron. 

4. In dyspepsia, for weakness in the epigastrium. 

5. In proctalgia, after the stool ; it is distin- 
guished by stitches up into the abdomen ; it is not 
indicated in fissure of the anus, which calls for 
Nitric acid and Plumbum. 

6. For haemorrhoids after labor. 

7. For ascarides. 

8. For the vomiting of pregnancy, if appetite, 
salivation, copious lemon-colored urine, etc., be 
present, and clavus hystericus. 

9. In spasmodic cough. Note the sensation of 
constriction felt in the rectum and in the trachea. 

Ignatia has a general correspondence to hys- 
teria ; to the form characterized by a mental 
character, which is mild, gentle, yielding though 
whimsical (else it were not hysteria), and intro- 
verted. There is another form represented by 
Platina, which drug will be the subject of the 
next lecture. 



PLATINA. 



THE physical and chemical properties and reac- 
tions of this metal are described from another 

chair. 

It finds no place in the Pharmacopoeia of 
England cr the United States. 

Trousseau and Pidoux cite a few vague and 
indecisive experiments upon animals and men with 
double Chloride of Platina and Sodium by Dr. 
Hcefcr in 1840, and therapeutic experiments by 
the same physician, who proposed to substitute 
Platina for Gold and for Mercury in the treatment 
of secondary and of primary syphilis and syphilitic 
rheumatism. 

Our knowledge of the action of Platina is 
derived exclusively from a proving by Stapf and 
Gross, two pupils of Hahnemann. It was first 
published in one of the earlier volumes of the 
" Archiv fur die Homosopathische Heilkunst." 

Eor medical use, chemically pure Platina is 

dissolved in aqtta regia. Into this solution a 

polished steel rod is plunged. The chloride is 

decomposed, and the resulting metallic Platina is 
II.— 10 



1 



130 



PLATINA. 



precipitated in the form of a fine clust upon the 
surface of the rod. It is carefully washed to free 
it from the acid, and is then triturated according 
to the rules of the homoeopathic pharmacy. 

The action of Platina is exerted, in the most 
marked and peculiar manner, upon the mind and 
disposition ; upon the second and third branches of 
the tri-facial nerve ; and upon the sexual organs of 
women. 

It acts, like Ignatia, much more upon the vital 
forces than upon the organic substance of the body. 

It further resembles Ignatia in the fact that it 
interferes with and deranges the co-ordination of 
functions, destroying the harmony with which 
related functions are performed in the healthy 
body. 

But the kind of perversion, and, in particular, 
the variety of mental perversion and disturbance 
produced by it, are altogether different from those 
produced by Ignatia, so that, if Ignatia correspond 
to one form of hysteria, Platina corresponds to a 
form altogether different. 

The kind of pain characteristic of Platina is a 
cramp-like, squeezing pain, — a kind of crushing 
together. It is peculiarly characteristic of this pain 
that it begins gently, gradually increases, in severity, 
and then gradually becomes less severe, until at 
last it ceases. In this respect Platina resembles 
Stannum. 

Most of the Platina symptoms are worse when 
the patient sits or stands, and are ameliorated by 



PLATINA. 



walking. They generally occur, or are aggravated, 
at night. 

It has been remarked as a peculiarity of the 
sleep of Platina, that however quiet the sleep may 
have been and however sound, the patient is always 
found, on awaking, to be lying on the back with 
the thighs drawn up upon the abdomen, with one 
or both hands above the head ; and there is about 
or a little before the time of waking, a disposition 
to uncover the lower extremities. In connection 
with the form of hysteria to which Platina will be 
seen to correspond, and particularly with the nym- 
phomania, which is a variety of this form of 
hysteria in which Platina has proved itself a most 
valuable remedy, these symptoms of the sleep have 
a great significance. 

The action of Platina may be more particularly 
delineated as follows : 

At first, the prover experiences a distressing 
anxiety, a kind of deadly apprehensiveness, with a 
sensation of trembling throughout the body, a 
great disquiet of mind, which does not admit of 
repose ; the prover believes death to be impend- 
ing and has a great dread of it. (Like Aconite.) 

Now, instead of grief, or despondency, or resig- 
nation under this state of things, there is great 
irritability, great susceptibility to anger and vex- 
ation ; a trifling grievance produces a profound 
vexation, under the effects of which the prover 
remains a long time vexed, unfriendly, in fact "in 
the sulks." 



132 



PLATINA. 



Then, as the action of the drug becomes more 
profound, there is an alternation of this depression 
and this sulky despondency with an unnatural 
liveliness and gayety, so that the patient laughs 
violently, and this perversion of the natural func- 
tions (and of the co-ordination of the functions) 
of the sensorium goes so far that the prover laughs 
immoderately, even at the saddest objects. 

Then finally there comes a state of mind, the 
outgrowth and development of that last described, 
in which the prover displays a most exalted and 
overweening self-esteem, overestimating herself 
beyond all reason, and entertaining a correspond- 
ingly low and contemptuous opinion of all sur- 
rounding objects and persons, even the most 
venerable and respectable ; nay, this opinion is the 
more depreciating the nobler and more worthy the 
objects of it. 

The extent to which this perversion of mind is 
sometimes carried, and the ludicrous scenes to 
which it gives rise, are among the curiosities of 
the materia medica. This is a characteristic action 
of Platina, and cases of disease in which some- 
thing analogous does not appear, are rarely cured 
by Platina. 

Headache also is produced. This presents the 
characteristic feature of Platina. A squeezing, con- 
stricting pain, as if a board were pressed against 
the forehead, as if the head were compressed, 
screwed together, etc., and at the same time a 
sensation of numbness in the head. Like other 



PLATINA. 133 

Platina pains it begins gently, gradually increases 
in severity, and then gradually diminishes. Some- 
times the cramping pain is in the temple, and then 
it is conjoined with similar pain in the zygoma 
and malar bone, constituting the temporo-facial 
neuralgia of Platina. 

Besides these sensations, there is a variety of 
headache, consisting of a compression of the fore- 
head and temples, as if everything would come 
out at the forehead ; much worse from stooping 
forward, as well as from the slightest movement. 
It is preceded by anxiety, and by burning heat 
and redness of the face (a kind of "sick head- 
ache "). 

There are painful crampings and compression 
in the circumorbital regions, and particularly in the 
supra-orbital, and in these the globe of the eye 
sometimes participates, feeling sore. 

The peculiar compressing, cramping pain is felt 
in the malar bone and zygoma, with a kind of 
numbness and at the same time a burning pungent 
sensation, inducing one to rub or scratch the part. 

This corresponds well to a certain form of 
facial neuralgia. It resembles most closely that of 
Verbascum thapsus. 

It is distinguished from that of Arsenicum in 
this, that in the latter the pains are burning, and 
that they dart quickly, like red-hot needles, from 
place to place. 

The pain of Verbascum is like a crushing with 
tongs. Platina has steady compression. 



134 



PLATINA. 



That of Spigelia is a shooting or piercing, and 
has its chief seat in the globe of the eye. 

Chamomilla has aggravation by heat, and is 
further distinguished by the great impatience of 
pain exhibited by the patient. The neuralgia of 
Capsicum is provoked by external pressure, and 
is a fine line of pain coursing along the nerve. 
The constitutional symptoms still further aid us in 
distinguishing the indications for the several drugs 
which produce a form of prosopalgia. 

Noises in the ears, of the greatest variety, are 
produced in abundance by Platina. There is little 
evidence of any organic lesion. (This might lead 
to the selection of Platina for what is called "ner- 
vous deafness.") 

There is little that is distinctive in the action 
of Platina on the digestive canal, except in so far 
as the stool is concerned. 

This is retarded ; the faeces are scanty, hard, 
evacuated with difficulty and almost dry. The evac- 
uation requires great effort of the abdominal mus- 
cles ; and this is followed by a peculiar sensation 
of weakness in the abdomen, or by a shuddering 
throughout the body. 

In the rectum there are occasional sharp stitches, 
compelling one to cry out. In this Platina resem- 
bles Ignatia. 

The menses appear much too early and are 
very copious. Moreover, there are uterine haemor- 
rhages, copious and often recurring. As in most 
uterine haemorrhages, the color and consistency of 



PLATINA. 



135 



the blood furnish a valuable characteristic of the 
remedy. That of Platina is very dark, and, with- 
out being coagulated in distinct masses, it is thick 
and tarry. It is accompanied by pains in the 
sacrum ; but these sacral pains are only felt as a 
sequel to pains which have first been felt in the 
groins, causing a dragging and pressing downward 
in the entire pelvis, and have then passed to the 
sacrum ; and, furthermore, there is always in con- 
nection with this metrorrhagia of Platina an unnat- 
ural sensibility and irritability of the genital organs. 

It may be remarked of the pains of Belladonna 
that they pass through the pelvis either in its 
anterior-posterior or in its lateral axis ; while the 
pains of Pulsatilla and Sepia pass around the 
pelvis from sacrum to groin, and are conjoined 
with scanty menstruation instead of profuse. 

The labor-like pains of Chamomilla are very 
severe, and the metrorrhagia is in paroxysms, the 
blood being thin and rather light, with firm coagula. 

The flow of Secale cornutum is thin and pain- 
less, so is that of China. 

Crocus has a dark flow, but it is not attended 
by a bearing-down pain, but rather by a sensation 
as of a living body moving in the abdomen. 

Millefolium and Sabina both produce a light- 
colored, florid uterine haemorrhage. 

It is, thus, not difficult to distinguish the uterine 
flow of Platina from that of other drugs. 

Attention should again be called to the hyper- 
sensitiveness and irritability of the genital organs. 



136 



PLATIXA. 



These symptoms, together with those of the sleep 
already mentioned, have led to the use of Platina 
in cases of nymphomania ; it has been of the 
greatest service, comparing with Hyoscyamus. 

The organs of respiration are not especially 
affected. 

In the trunk, we have first a weakness of the 
neck ; the patient cannot hold up his head, and 
along with this, a kind of tensive numbness. There 
is pain in the spine and sacrum, as if they were 
broken, especially after a long walk or on bending 
backward. 

In the extremities are felt cramp-like, press- 
ing and compressing pains, such as are elsewhere 
experienced, conjoined with a kind of burning and 
numbness. 

PRACTICAL APPLICATIOXS. 

Of the uses of Platina in treating disease, but 
little remains to be said. 

The mental symptoms denote the forms of 
hysteria in which it is useful. Whereas Ignatia 
corresponds to cases in which there is a disposi- 
tion to grieve, to brood in melancholy sadness 
over sorrows, whether real or imaginary, Platina, 
on the other hand, belongs to a variety in which 
the mind rises in defiant and distorted superiority 
over the causes of vexation or sorrow ; becomes, 
first, demonstratively apprehensive, then alternately 
demonstratively lachrymose and boisterously merry, 



PLATINA. 



137 



and at last absurdly supercilious, — a genuine repre- 
sentation of Mrs. Lofty. But, whatever the frame 
of mind may be, it is always demonstrative, and 
this is the character of Platina ; the personality of 
the patient is obtruded on one's notice. 

The character of Ignatia, on the other hand, is 
that it is undemonstrative ; the sufferings and per- 
versions are not obtruded on one's notice. 

The peculiarities of the neuralgia and of the 
uterine haemorrhage, which are marked Platina 
symptoms, have already been pointed out. 

It remains only to call attention to the stool, 
and to say that in the constipation which is often 
so troublesome a concomitant of pregnancy, Platina 
is often a valuable remedy, standing in the same 
rank with Sepia, Alumina and Plumbum. 



SEPIA. 



SEPLE SUCCUS. 



HE juice of the cuttle-fish ; a blackish fluid 



X contained in the abdomen of the animal, and 
from which the animal has the power of projecting 
the juice into the surrounding water. 

For medicinal purposes the juice is carefully 
dried, divested of its membranous envelope, and 
prepared by trituration according to the rules of 
the homoeopathic pharmacy. 

Although Sepia has no place in the pharma- 
copoeia of the old school, and is, indeed, so little 
known by them that one of their foremost writers 
has endeavored to fling ridicule on homceopathists 
by stating that they ascribe medicinal virtues to 
the cuttle-fish bone, which is mere carbonate of 
lime, it is a singular fact that Hippocrates set a 
high value on Sepia as a remedy in diseases of 
women and in dysmenorrhea, and that Galen 
ascribes to it tonic and stomachic qualities ; while 
Marcellus recommends it for gravel and for the 
removal of freckles. A very singular anticipation 
by the ancients of the exact deductions from the 
homoeopathic law. 




SEPIA. 



J 39 



Sepia is one of our most important remedies. 
Its action pervades almost the entire organism and 
is very enduring, the effects of a single dose 
often lasting for many weeks. 

Upon the vital force and the organic substance 
it acts with equal energy. 

The sphere of action comprises, in particular, 
the sexual organs of women, the gastro- intestinal 
tract and its appendages, the skin and glands, and 
the nervous system of animal life. 

The symptoms are most apt to occur or to be 
aggravated when the patient is at rest, sitting 
quietly, in the forenoon or evening; and to be 
relieved by vigorous exercise in the open air. In 
general, the aggravation occurs about the middle 
of the forenoon ; especially the sense of " sinking 
at the pit of the stomach," which attends many 
uterine disorders. 

Sepia induces a tendency to free and sudden 
perspiration from a nervous shock or from exer- 
tion, but it is noteworthy that this perspiration 
comes out after the exertion is over or the shock 
is past, and when one is sitting quietly. (Calcarea 
carbonica has sweat during the exertion.) 

Sepia produces (and cures) what are well 
known as "hot flashes" — sudden accessions of 
heat, followed by a momentary sweat and weak- 
ness and disposition to syncope. These are 
frequent and very annoying incidents of the cli- 
macteric period in women. Lachesis resembles 
Sepia in this. 



140 



SEPIA. 



In many respects the symptoms of Sepia closely 
resemble those of Pulsatilla. As would be natu- 
rally inferred, these remedies often act as mutual 
antidotes ; and so it happens that frequently, when 
they are given in alternation, as the custom is of 
some physicians, no result is observed. In such 
cases, it is often sufficient to suspend the adminis- 
tration of one of them in order to get a prompt 
and satisfactory effect from the other. 

The skin affections of Sepia are among its 
most important symptoms. We find itching of the 
skin, and itching vesicles and papules on the face, 
hands and feet ; and also a vesiculo-pustular erup- 
tion in the hollow of the joints of the knee and 
elbow. After the Sepia eczema there is abundant 
desquamation. 

While speaking of the skin, it should be men- 
tioned that Sepia produces on the lower lip a 
swelling with a soreness, burning pain and a 
pricking as from a splinter of wood. This symp- 
tom, together with the constitutional symptoms, 
has led to the use of Sepia in the treatment of 
epithelial cancer of the lower lip, two cases of 
which, cured by Sepia 803 , have come within my 
personal knowledge. 

In like manner, the other skin symptoms have 
induced the successful use of Sepia in cases of 
Rhus poisoning. 

The fever of Sepia is incomplete. Chilliness 
predominates, but, like the heat, is fugitive and 
transient. Perspiration is copious, especially at 
night, and is conjoined with great weakness. 



SEPIA. 



141 



The disposition peculiar to Sepia is a depressed, 
anxious and fearful state of mind, with a sense of 
helplessness, and yet great susceptibility to excite- 
ment, and still more to terror, frequent attacks of 
weeping, and despair of life. 



SPECIAL ANALYSIS. 

Headache. Chiefly pressing and throbbing, with 
a kind of rush, of blood to the face, which becomes 
red and hot, even to the ears. No general fever, 
however. General aggravation from motion. Itch- 
ing of the scalp and falling out of the hair. 

Eyes. The sense of vision is affected. There 
is photophobia by day, and a white flickering 
before the eyes, like a thousand suns or sparks or 
black specks ; around the candle-flame there is a 
green halo. On attempting to read or write, the 
vision becomes obscured. 

There are supra-orbital pains. The eyelids 
pain on awaking, as if too heavy, as if paralyzed, 
corresponding to ptosis — a malady in which Sepia 
has often been given successfully. 

Then, conjunctivitis with biting and burning and 
itching, but very scanty secretion of mucus or pus. 

The face is the seat of eruptions already 
described. Moreover, on the forehead come irreg- 
ular non-elevated brown spots, well known as 
"liver spots." The complexion becomes yellow 
and earthy. There are often, in connection with 
the headache or with uterine disorder, tearing pains 



142 



SEPIA. 



in the facial bones and in the teeth. Finally, a 
characteristic symptom of Sepia is a brown discol- 
oration extending across the bridge of the nose 
like a saddle. 

In the mouth often form painful vesicles and 
ulcers — a form of stomatitis. 

The gums swell and bleed easily. The teeth 
become loose. There is toothache, digging, tear- 
ing and gnawing pain, sometimes in a single tooth, 
sometimes in a whole row, aggravated by warmth. 
The toothache is generally a sympathetic concomi- 
tant of uterine disorder or of pregnancy. 

The tongue is often sore, as if scalded. Sali- 
vation occurs, the mouth filling with a saltish fluid, 
while at the same time the throat and fauces are 
so dry that the patient can hardly utter a sound. 
(This closely resembles the salivation of pregnancy.) 

The taste in the mouth is offensive, slimy, putrid 
like a bad egg, with eructations of the same char- 
acter ; or bitter, often bitter early in the morning, 
this ceasing after breakfast. 

There are abundant eructations ; hiccough after 
eating ; nausea and vomiting of bile, or vomiting 
of bile early in the morning on rising, with, during 
the day, attacks of constriction in the hypochon- 
dria, and nausea. 

There is no thirst. Appetite fails ; all food 
tastes alike. The stomach feels empty and weak 
with nausea at thought of food. A characteristic 
symptom is a peculiar faint sinking at the pit of 
the stomach, which is not necessarily painful to 
pressure. The faintness of Mercury is accompanied 



SEPIA. 



1 43 



by tenderness ; so is that of Calcarea carbonica. 
(Hydrastis.) Pressure and fullness a're also some- 
times felt. There are stitches in the region of 
the liver, which is sometimes sensitive to pressure. 
Also a fullness in the hepatic region and a 
pinching pain. It is peculiar to Sepia that the 
pains in the hypochondria are more tolerable 
when the patient lies on the painful side, while 
with Magnesia muriatica the opposite condition 
obtains. (Bcenninghausen.) 

The abdomen is often distended with flatus. 
There are cutting pains horizontally across 
the abdomen, sometimes extending up into the 
chest. 

In the rectum and anus a constricting pain 
which extends into the perinseum or the vagina, 
sometimes up into the abdomen. Sometimes a feel- 
ing of soreness and a kind of pressure outward, 
cutting, burning and itching. Hemorrhoidal tumors 
occur, which are painful and bleed. After stool, 
emptiness and weakness in the abdomen. 

The stool is scanty and infrequent. 

The evacuation of urine is preceded by press- 
ure and tenesmus ; it is frequent, painful, and often 
ineffectual until after long waiting and effort. At 
night frequent desire to pass water, which starts 
tardily, and flows slowly. Again, involuntary mic- 
turition at night. 

On the sexual organs of women Sepia acts 
very distinctly. Along with cutting pains in the 
abdomen, a pressure is felt on the uterus down- 
ward, as if everything would fall out. 



1 44 



SEPIA. 



The menses come too early, but are scanty. 
They are preceded by violent aching in the abdo- 
men, causing even faintness, and by chilliness and 
shuddering. 

During the menses, restlessness, drawing pains 
in the limbs and abdomen. Palpitation and dys- 
pnoea, with toothache and headache and epistaxis ; 
with depression of mind. 

At other times than the menstrual period, fre- 
quent stitches in the vagina in paroxysms, with or 
without a watery yet lavish leucorrhcea. The leu- 
corrhcea is rarely acrid, whereas that of Kreosote 
is very acrid. 

Sepia produces (and cures) a dry, fatiguing 
cough, provoked by a sensation in the region of 
the stomach, and seeming to come therefrom ; or 
the cough comes, as it seems, from the abdomen. 
A symptom which I have often verified in practice. 

Then again a cough with copious, saltish expec- 
toration, white or grayish yellow : the cough being 
attended, as all the Sepia symptoms are, by acces- 
sory symptoms, such as stitches in the epigastrium 
or head, faintness, nausea, etc. 

From these and other similar symptoms, we 
draw our indications for Sepia in pulmonary con- 
sumption. 

It produces various forms of oppression of the 
chest, burning in the chest and palpitation. 

In the sacro-lumbar region Sepia produces pain, 
which generally is relieved by sitting or lying, 
worse when standing or walking. The backache 



SEPIA. 



145 



of Belladonna is worse when lying down ; better 
when sitting. Sometimes the reverse. 

It is a pressing, dragging pain over the sacrum 
and at the same time over the hips, and a burn- 
ing pressure in the spine ; also drawing pressure 
and burning pain across the dorsal region and 
under the scapula (often like that produced by 
sewing). 

In the extremities, stitches and sticking, draw- 
ing pains, with lassitude, coldness of the feet, but 
sometimes only of the knees ; sweat of the feet. 
The eruptions already described. 



PRACTICAL APPLICATIONS. 

Among the general affections for which Sepia 
has been found a useful remedy may be men- 
tioned, first: Various forms of skin disease, and in 
particular those of a vesicular character, attended 
by much itching and followed by desquamation. 
The vesicular eruption is not attended by the 
erysipelatous inflammation of the contiguous skin, 
such as is characteristic of Rhus toxicodendron ; 
and this serves in part to distinguish these drugs. 

Sepia is especially successful in the treatment 
of herpes circinnatus or ringworm, when this 
occurs in isolated spots. Calcarea carbonica (or 
acetica) is also useful in this affection. The dis-* 
tinction is to be found in the constitutional symptom. 
When, however, the herpes circinnatus occurs, not 
II.— 11 



146 



SEPIA. 



in isolated patches, but over a great portion of the 
body in intersecting rings, and attended by heat, 
itching, fever and great constitutional disturbance, 
Tellurium seems to be indicated, as appears from 
a proving of that drug in the "American Homoeo- 
pathic Review." 

In connection with skin symptoms, may be 
mentioned again, the brown discolorations of the 
forehead and cheeks and of the skin across the 
bridge of the nose, known as "liver spots," and 
which are very frequently found conjoined with 
constitutional symptoms which indicate Sepia as a 
remedy, these symptoms being particularly those 
of the hepatic region and of the uterus and its 
appendages. 

In paralysis of the upper eyelid — ptosis — Sepia 
often effects a cure ; also in certain perversions of 
the function of vision. 

The neuralgia, the toothache and the headache 
of Sepia, are almost always conjoined with some 
disorder of menstruation, with pregnancy, or with 
some disease of the sexual organs of women. 
And it is peculiar to Sepia that, along with its 
symptoms of disease in the sexual organs, there 
occurs a considerable number of sympathetic 
symptoms in distant organs, e. g. : the toothache, 
headache, salivation, neuralgia. 

Attention has been called to the fact that two 
cases of epithelial cancer of the lower lip have 
been cured by Sepia. A third case of this disease 
is so interesting as to be worthy of narration. 



SEPIA. 



147 



An epithelial cancer, far developed, had been 
excised. The wound healed kindly. After a few 
months the patient began to emaciate, and to 
exhibit every sign of cancer cachexy. The decline 
was alarmingly rapid. Eminent surgeons diagno°- 
ticated internal cancer. No hope of recovery was 
entertained. The complex of symptoms indicated 
Sepia, which was given, 200, and effected a com- 
plete and rapid restoration of health. The health 
remains good to this day (ten years). 

In chronic or sub-acute hepatitis, Sepia does 
good. Its chief use, however, overshadowing all 
others, is in displacements and diseases of the 
uterus. In prolapsus it is the remedy, par excel- 
lence. Yet not to be used to the exclusion of Nux 
vomica, Pulsatilla, Belladonna and Podophyllum. 
The simultaneous irritability of the bladder and the 
presence of leucorrhcea, together with the hot 
flashes and the sympathetic affections of remote 
organs, serve especially to indicate it. 

Sepia is rarely indicated by these symptoms 
but that there is present the peculiar "sinking and 
all-gone sensation " in the pit of the stomach, 
almost producing faintness, and relieved by lying 
down and by taking food or wine. 

In amenorrhcea or retarded and scanty men- 
struation, it is often indicated. 

Experience has shown its value in cases of 
ulceration and congestion of the os and cervix 
uteri. Its use in appropriate cases supersedes all 
local applications, which in the vast majority of 



148 



SEPIA. 



cases are not simply unnecessary, but are i ^ry 
mischievous. The same may be said of mechanical 
contrivances in uterine displacements, especially 
pessaries and internal supporters of all kinds. 

Sepia is also a remedy in functional derange- 
ments of the liver. 

Medical practitioners, like other men, are apt 
to "run in grooves," and the grooves grow deeper 
by use. With regard to the materia medica, they 
are apt to remember of each remedy some one 
or two applications in which it is eminently useful, 
and to forget or ignore many others in which, 
though, perhaps, less frequently indicated, it is 
equally valuable. 

Thus, every one has in mind the virtues of 
Silicea in suppurative inflammation of connective 
tissue, while comparatively few might think of it 
as a remedy in cerebro-meningitis, or in neuralgia, 
or in epilepsy. 

Sepia, in like manner, suggests itself to every 
practitioner in cases of chronic uterine disease, 
and its value in such cases has caused it to be 
classed, in the medical mind, with remedies speci- 
ally adapted to chronic cases. The remarks I 
purpose to make will show, I think, that it may 
also be a remedy for acute conditions. They will 
serve, likewise, to call attention to the re-proving 
of Sepia, made under the direction of the Bureau 
of Materia Medica of the American Institute of 



SEPIA. 



149 



Homceopathy, and published in the Transactions 
of that body for 1875. While this proving con- 
firms in a remarkable manner, the Hahnemannian 
proving of Sepia, and may be said to have added 
little absolutely new to our knowledge of this drug, 
it certainly presents, in a definite form, symptoms 
that are somewhat shadowy in the original proving, 
and thereby furnishes evident indications, where 
formerly these were perceptible only to acute 
observers. 

I propose to consider only the relations of 
Sepia to "functional derangements of the liver," 
taking from Murchison's recent work,* the symp- 
toms cf these derangements and placing under 
each of these symptoms the corresponding group 
of Sepia symptoms. 

Before describing the symptoms of functional 
derangement of the liver, Dr. Murchison states 
that the functions of the healthy liver are — not 
simply nor chiefly the secretion of bile — but 

" 1. The formation of glycogen, which contrib- 
utes to the maintenance of animal heat and to 
the nutrition of the blood and tissues, and the 
development of white blood corpuscles. 

" 2. The destructive metamorphosis of albu- 
minoid matter, and the formation of urea and other 
nitrogenous products, which are subsequently elimi- 
nated by the kidneys, these chemical changes also 
contributing to the development of animal heat. 

* " Functional Derangements of Lectures, etc., delivered in March, 
the Liv<=r: being the Croonian 1874, etc., London." 



SEPIA. 



" 3. The secretion of bile, the greater part of 
which is re-absorbed, assisting in the assimilation 
of fat and peptones, and probably in those chemi- 
cal changes which go on in the liver and portal 
circulation, while part is excrementitious, and in 
passing along the bowels stimulates peristalsis and 
arrests decomposition." 

A "functional derangement" may be a modifi- 
cation or an arrest of any one or several of these 
healthy functions. 

1. If the power to convert glucose into glyco- 
gen be impaired by functional derangement of the 
liver, glucose passes into the general circulation, is 
eliminated by the kidneys, and we have one of 
the several forms of glycosuria, — forms which agree 
in this one symptom (sugar in the urine), but 
differ profoundly in the pathological conditions on 
which this symptom depends, and in the indications 
for, and their amenability to, treatment. The form 
we have described is often transient, and always a 
mild and curable form of diabetes ; or, this glyco- 
genetic function may be modified in another way, 
and we may have a more serious form of glyco- 
suria by an increased conversion of glycogen into 
sugar, from hyperemia of the liver depending on 
paralysis of the vaso-motor nerves, resulting from 
irritation of the roots of the pneumo-gastric nerves, 
injuries of the spinal cord, poisoning by curare, etc. 

2. When the function by which the liver disin- 
tegrates and eliminates albuminoid matter is imper- 
fectly performed, the disintegration stops short of 



SEPIA. 



the formation of urea which is soluble ; and prod- 
ucts more sparingly soluble, and which are less 
completely oxidized, than urea, are formed, viz., 
uric acid, etc.; or products still less oxidized, such 
as leucin and tyrosin, which we find in acute 
atrophy of the liver when this function of that 
viscus is almost abolished. Where, under this 
functional derangement, uric acid is formed instead 
of urea, we find in the urine deposits of uric acid, 
of urates, and abnormal pigment. 

Such is a brief statement of Murchison's views 
of the functions of healthy liver, and the results of 
some of their derangements. I shall restrict my 
remarks upon Sepia to the second form of derange- 
ment above described, viz., that of the function by 
which albuminoid matter is disintegrated and elim- 
inated, and the derangement of which is manifested, 
among other symptoms, by excess of uric acid and 
urates in the urine. 

Murchison gives the following names of diseased 
conditions resulting from this derangement: 

1. Atonic dyspepsia, of which the symptoms 
will presently be given in detail. 

2. Gout — anomalous or regular; urates in the 
blood, and deposited in or near the joints. 

3. Urinary or biliary calculi. 

4. Granular degeneration of the kidneys, from 
their constant work in eliminating urates. (Dr. 
Geo. Johnson.) 

The symptoms of the atonic dyspepsia are 
given more particularly by Murchison, as follows : 



SEPIA. 



After each group I cite, from the new or from 
Hahnemann's proving, the corresponding Sepia 
symptom : 

1. Tongue : that of atonic dyspepsia, large, 
pale, flabby, indented. Sepia : tongue coated brown 
or yellow (148, 149); tongue feels too large. (155.) 

2. Appetite good, but suddenly satisfied ; loath- 
ing of fat. Sepia : sudden craving, sudden satiety 
(185, 184) ; good appetite, but loathing of meat. 
(Hahn., 510, 522.) 

3. Bitter or coppery taste ; worse in the morn- 
ing. Sepia: putrid, insipid taste (177, 178); bitter, 
repulsive taste in the morning. (Hahn., 499.) 

4. Flatulence (from lack of bile?). Sepia: 
abdomen very much distended after the least bit 
of food. (207, 215.) 

5. Constipation, from lack of normal stimulus 
to the excretion, and with great depression of spirits; 
or there may be pale or dark offensive diarrhoea. 
Sepia : constipation ; seems to have lost power 
(243, 241) ; constipation, with bleeding and weight 
and pain in the rectum (236) ; only small, hard 
lumps passed (241); hard stools; faeces covered 
with mucus, followed by slimy, bilious or catarrhal 
stools. (255, 256.) 

6. Intestinal haemorrhage ; haemorrhoids. Sepia: 
considerable bleeding from the rectum and intense 
bearing down at the anus. (261, 262.) 

7. Hepatic pains ; weight, fullness, tightness ; 
worse when lying on the left side. Sepia : as if 
the abdomen were full and bloated across the epi- 



SEPIA. 



I 53 



gastric region (214, 215) ; as if a load rested on the 
epigastrium (217); soreness around the umbilical 
region on pressure, especially on the right side 
(221) ; Bcenninghausen names Sepia under the rubric 
" worse from lying on the left side." 

8. Jaundice (?). Sepia : yellow face and whites 
of eyes. (Hahn., 325.) 

9. Aching of the limbs and lassitude. Sepia : 
weakness and aching of the thighs and legs (419- 
421); general weariness and -prostration in the joints. 
(422.) 

10. Pain in the right shoulder and about the 
scapula. Sepia : long-continued pain under the right 
shoulder. (410, 413.) 

11. Hepatic neuralgia, with great depression of 
spirits. Sepia : stitches in the hypochondria, across 
the abdomen, making her cry out (Hahn., 626) ; 
frequent stitches under the right ribs. (Hahn., 
627, 629, and 624, 625.) 

12. Cramps in the legs. Sepia: cramps in the 
calves at night. (Hahn., 13 10- 13 14.) 

13. Dull headache in the forehead and occiput 
in the morning on waking, lasting part of a day, or 
several days, with constipation and pain in the right 
hypochondrium. Sepia : dull, stupid headache, with 
great mental depression (40-43) ; dull pain over 
both eyes (55) ; dull headache through the temples 
and forehead (59) ; waked with dull headache in 
the back of the head (74). 

14. Vertigo and dim vision. Sepia: dizziness (35 
Hahn., 87-100); obscured vision. (Hahn., 258, 259.) 



154 



SEPIA. 



15. Noises in the ears. Sepia: both ears feel 
stopped (in); ringing, singing, roaring, etc. 
(Hahn., 293-304.) 

16. Sleeplessness. Sepia: restless nights; tired 
mornings (504); disturbed sleep. (508, 509, 511, 
512.) 

1 7. Depression of spirits ; irritability of tem- 
per. Sepia : mental depression ; very low spirited, 
with headache (2 — 5); very irritable; very cross. 
(5, 6, 10, 12.) 

18. Palpitations and fluttering of the heart. 
Sepia: palpitation, very nervous (360, 365); seemed 
as if the heart occupied all .the cavities of the body 
(359); pulsation with soreness in the stomach (199.) 

19. Irregularities of pulse; intermission (which 
is always clue rather to hepatic indigestion than to 
cardiac disease ; intermission of pulse. (Hahn., 
1098, 1099.) 

20. Feeble circulation ; anaemia. Sepia : pale, 
sickly aspect. (Hahn., 324.) 

21. Angina pectoris, Sepia (?). 

22. Pulsations in various parts of the body, 
especially in the epigastrium. Sepia : pulsations 
felt in the body, in the head and extremities, day 
and night, especially in the night. (Hahn., 1409, 
1410.) 

23. Urine heavier than normal; it deposits uric 
acid and urates. Sepia : every prover noticed 
marked diminution in the quantity and increase in 
the specific gravity of the urine, which depos- 
ited uric acid and urates. This was reported by 



SEPIA. 



!55 



provers of both sexes, and from various potencies 
of Sepia. 

24. Chronic catarrh of the fauces. Sepia : feel- 
ing of rawness in the posterior fauces, etc. (165, 
167.) 

25. Chronic bronchitis. Sepia: coughing spells 
in the morning, with either difficult expectoration, 
or copious sputa, easily raised ; harsh, dry cough. 
(342, 344-) 

26. Spasmodic asthma. Sepia : tightness and 
constrictive sensation in the chest. (346.) 

27. Eczema, lepra, psoriasis, lichen, urticaria, 
boils, pigment spots, pruritus. Sepia: vesicular, 
papular and pustular eruptions (484-495); itching 
(484) ; yellow spots on the face and a yellow patch 
over the dorsum of the nose. (Hahn., 326.) 

In an excellent physiological study of Hahne- 
mann's proving of Sepia, Dr. V. Meyer of Leip- 
zig, in 1853, used the following language: "This 
remedy operates especially on the portal system, 
by retarding the circulation, and causing an over- 
loading of the vascular system with venous blood, 
or with blood more or less resembling venous. A 
plethora venosa, as it is called, gives rise to most 
of the various symptoms. The pathological pro- 
cess is also marked by a state of depression. * * 
All further morbid conditions are but secondary." * * 
" All disorders of the portal system must first affect 
the neighboring organ, the liver." (" Homceopath- 
ische Vierteljahrschrift," iv., 2. Translation in "Brit- 
ish Journal of Homoeopathy," xiii., pp. 635, 636.) 



SEPIA. 



Cases illustrating the use of Sepia in acute disease, 
connected with functional deraiigement of the 
liver. 

Case' i. August, 1875. A lad, seven years old, 
was brought home from the country, said to be 
suffering: from remittent fever ; he had been ill 
three weeks, and presented the following symp- 
toms : febrile condition persistent, very weak, keep- 
ing his bed, extreme depression of spirits and 
irritability of temper, occipital headache, sudden, 
excessive desire for food, but eats only a small 
quantity. Two or three stools daily and one or 
two at night, of normal consistency ; but clay- 
colored and offensive. Successive outbreaks of 
furuncles on the nates ; on the right side of the 
abdomen, just below the arch of the ribs, a very 
tender spot which is the seat of constant pain ; the 
whole right hypochondrium is tender and heavy ; 
aching in the right shoulder, restless sleep ; the urine 
has a pink deposit, stains every thing it touches 
red and stains the vessel ; heavy sweats at night. 
He is reported to have had Podophyllum, China, 
Bryonia, etc., etc., without perceptible effect. 

I gave Sepia 30 trituration, in solution, a dose 
every four hours during the day. In two days a 
vast improvement was manifest; and in a week he 
was perfectly well, and has so continued to the 
present. Improvement was noticed first in his 
fever, spirits and temper, then in his appetite and 



SEPIA. 



157 



digestion ; then the pain and soreness vanished ; 
then the stools and sleep became normal ; last of 
all, the urine became normal. 

Case 2. A lady, aged thirty, has been ill nine 
or ten days ; is in a remittent febrile condition 
with evening exacerbations, no chills, pulse at eleven 
A. m., ninety-six. Aching weight and soreness in 
the right hypochondrium, and distress and aching 
in right shoulder and scapula ; cheeks flushed, the 
forehead and conjunctivae yellow ; irregular yellow 
patches on the forehead, lassitude ; the limbs and 
back aclie, obstinate constipation and occipital 
headache ; anorexia, she loathes fat and milk ; 
thirst, tongue flabby and indented, great flatulence 
after food, restless sleep, dry hot skin, urine scanty 
and loaded with urates. Her disease is said to 
have been pronounced remittent fever and pre- 
scribed for as such. She has taken Podophyllum 
and she knows not what else. 

I gave Sepia 30 trituration, in solution, a dose 
every four hours. In twelve hours the fever had 
gone and did not return, the side was better, the 
bowels had moved ; in a week she was entirely 
well. 



MUREX PURPUREA. 

A VISCOUS juice, found in a small sack 
between the heart and liver of the mollusks 
of the genus purpura, of the family buccinidae, and 
also of the muricidse. A similar sack and juice are 
found in several conchiferse belonging to the family 
limacidse. 

When brought into contact with the atmosphere, 
this juice becomes successively yellow, green, blue, 
and finally, a reddish purple. It is insoluble in 
water, alcohol or ether ; consequently for homoeo- 
pathic use the attenuations are prepared by tritu- 
ration. 

The proving which we possess was made chiefly 
under the observations of the late Dr. Petroz of 
Paris. Some additional observations have been 
collected by Dr. Hering ; and a resume of our 
knowledge to the present date was published in 
the "American Homoeopathic Review," vol. iv., 
1864. 

In its origin, Murex is very closely akin to 
Sepia ; and it will be perceived that its pathogenesis 
closely resembles that of Sepia, especially in its 
relations to the female genital organs. What its 



MUREX PURPUREA. 



159 



analogies or contrasts may be, with reference to 
other organs or apparatus, we can hardly venture 
to conjecture, for our proving of Murex is frag- 
mentary, and the number of provers was very 
small. 

Head. Upon the sensorium, Murex produces a 
depressing effect. There is confusion of ideas and 
diminished intellectual activity. 

The pains are heaviness and pressure in various 
parts of the head, chiefly in the forehead, or, in one 
or the other temple. Heaviness or tightness in 
the head, relieved by bending the head backward. 

Stomach. A peculiar and distressing sensation 
of "sinking" or faintness or vacuity in the epigas- 
trium. The patients call it an "all-gone" feeling, 
something like the sensation produced by excessive 
hunger. Sepia has the same symptom, but in a 
less degree. 

A bdomcn. An acute sensation like a sharp point 
in the left side of the abdomen, which extends, 
and is felt in different isolated spots. The left side 
of the abdomen remained painful. 

Tension (painful) in the right hypochondrium. 
Uneasiness in the abdomen like that which is 
caused by the approach of the menses ; which, 
however, are retarded. 

Stool. Constipation, lasting several days. 

Anus. Pressure upon the anus like painful 
points. 

Genital Organs. Our symptoms relate only to 
those of women. 



i6o 



MUREX PURPUREA. 



In the right side of the uterus, acute pain, 
which crosses the body, and ascends to the left 
mamma. Pain in the uterus as if wounded by a 
cutting instrument. In the evening, two violent 
lancinations in an upward direction on the left side 
of the abdomen. Throbbings in the uterus. 

Vagina. Heaviness in the vagina during the 
pains in the abdomen. 

Pudenda. Sensation of weight and of dilatation 
in the labia majora. 

Functional Symptoms. Excitement ; sexual 
instinct so violent as to fatigue the reason. 

Platina has similar excitement. Hyoscyamus 
also, but with disturbance and perversion of the intel- 
ligent and moral sense, constituting nymphomania. 

Venereal desire, increased or renewed by the 
slightest touch. 

Discharges. The menses are delayed. After 
flowing a few days the menses cease, and after 
twelve hours re-appear. Sepia has a similar symp- 
tom. Kreasote the same, together with irritation 
of the bladder, and a very acrid discharge from 
the vagina, causing the pudenda and thighs to 
swell and become raw, burning and itching. 

Thick and greenish, or watery, leucorrhcea. 

Urinary Organs. In quantity the urine is 
diminished, but the calls to pass urine are more 
frequent and urgent than in the normal state, 
especially during the night. 

The urine is fetid, or has an odor like that 
of valerian. It has a white sediment, and its 



MUREX PURPUREA. 



161 



evacuation is followed by a discharge of blood 
or bloody mucus. (These symptoms occur in 
females, and probably this discharge is from the 
vagina.) 

Trunk. Pains in the loins, burning or exco- 
riating. Pains in the hips and loins when lying 
down, and especially in bed. Here we have a 
contrast to Sepia, the lumbar and coxal pains of 
which are relieved by lying down ; and a point of 
resemblance to Belladonna. 

Pains around the pelvis. 

Extremities. Pains and achine in the arms 
and legs. Feebleness, the limbs give way. Lassi- 
tude and fatigue ; disposition to lie down. On 
rising, acute pain in the middle anterior portion of 
the right thigh. It will not bear to be touched. 

Sleep. Drowsiness in the evening. But the 
sleep is disturbed by troublous dreams, by pains 
like menstrual pains, and by an urgent necessity 
to rise and urinate. 

These are in substance the symptoms ascribed 
to Murex. We gather from them and from clinical 
experience, that Murex acts peculiarly upon the 
sexual system of women ; although the pains in 
the right hypochondrium and the constipation point 
to an action on the liver similar to that of Sepia. 

Murex produces general lassitude and feeble- 
ness in the body and limbs, as well as in the senso- 
rium ; but the feeling of prostration is most marked 
in the sinking, " all-gone " sensation in the epigas- 
trium, which is very characteristic of Murex, and 

II.— 12 



l62 



MUREX PURPUREA. 



which is so frequent a concomitant of uterine dis- 
ease, especially of prolapsus uteri. 

In the loins and hips and around the pelvis, 
aching, drawing or burning pains, and pains and 
tenderness in the anterior part of the thighs, — 
such as often coincide with uterine disease, — are 
marked symptoms of Murex. 

Again, the irritation of the bladder, which does 
not tolerate a large accumulation of urine in it, — 
the desire to evacuate being sudden and urgent, — 
points rather to uterine than to vesical disease. 

Most peculiar to Murex, however, are the sen- 
sations ascribed to the uterus itself. First among 
these is a sensation described by one of Dr. Hering's 
provers as a "consciousness of the womb." Patients 
sometimes describe it thus: "I feel that I have a 
womb, and it is uncomfortable ; whereas when I 
am well I am not conscious of the organ." More 
positive symptoms are the lancination, cuttings and 
throbbings felt in the uterus, and chiefly on the 
left side. Finally the sensation of sharp pain pass- 
ing upward on the right side of the uterus, then 
crossing the body and extending to the left mamma. 

There is leucorrhcea, thick or watery. 

It is noteworthy that the sexual instinct is very 
active, and the susceptibility greatly increased, so 
as to annoy the subject. In this aspect Murex 
resembles Platina (and perhaps Phosphorus) and 
differs from Sepia. 

The applications of Murex follow directly upon 
this statement. In the " American Homoeopathic 



MUREX 



PURPUREA. 



Review," loc. cit., cases are given of its successful 
use in treating prolapsus uteri and other uterine 
affections. 

I have in my records a case of a large cyst, 
supposed to be connected with the left ovary, 
which occupied the space between the rectum and 
uterus and vagina, so as to obliterate the posterior 
cul de sac and almost occlude the vagina. In 
addition, it somewhat distended the abdomen. The 
patient had been confined to her room and bed for 
more than a year. The subjective symptoms so 
clearly indicated Murex that I gave the sixth. 
Whether it were mere coincidence or not I cannot 
say, but it is certain that within three weeks the 
tumor discharged a limpid fluid per vagina, and 
the local as well as general symptoms completely 
vanished, so that in a month thereafter the patient 
could walk freely and look after her housekeeping; 
nor has she since (for five years) been disabled or 
ailing. 



KREASOTUM. 



THIS remedy, of which a proving was pub- 
lished by Dr. Wahle in the "Archiv," and 
which, in Dr. Bcenninghausen's opinion, has not 
received from practitioners the attention which it 
merits, I mention here, because of the analogy 
of its action on the female sexual organs to that 
of Sepia and Murex. And for the reason that 
Kreasotum has been but little used in practice, and 
few of its symptoms have been verified by clinical 
experience, I shall not attempt a systematic state- 
ment or analysis of the pathogenesis, but proceed 
at once to symptoms. 

The Head. Dull feeling in the head, and 
as if a board were pressed against the forehead. 
Headache, as if the head were too full, and would 
burst out forward. In various parts of the head, 
pressing from within outward. Jerking, tearing and 
stitching pains in the anterior part of the head, 
semi-lateral, and extending to the cheeks, jaws, 
teeth and neck. Kreasote has proved curative in 
neuralgia, where the sensations were burning, and 
where the paroxysms were induced by talking, 



KREASOTUM. 



moving or sitting up or lying on the side not 
affected ; and attended by great excitability and 
nervous irritability. 

In the digestive apparatus, Kreasote produces, 
among other symptoms : rising of tasteless air after 
a meal, or of frothy saliva. Nausea and vomiting 
before breakfast, with tightness across the epigas- 
trium, and yet an inability to bear tight clothing. 
It is useful in the vomiting of pregnancy. 

Various pains in the abdomen, with constipation. 

Urinary Organs. The secretion of urine is 
reported as both diminished and increased. But 
whichever be the case, there is also a disposition 
to evacuate it more frequently than in health, 
especially at night, there being much pressure 
upon the bladder. Bcenninghausen calls attention 
to the value of Kreasote as a remedy in cases of 
incontinentia urinae nocturna, where the patient 
dreams he is urinating comme il faut. Sepia has 
incontinence during the first sleep. The desire is 
very sudden and imperative ; and, in women, the 
evacuation is attended and followed by much smart- 
ing and burning of the pudenda. The urine is 
often turbid and offensive, depositing a reddish 
sediment. This is similar to Sepia, of which a 
characteristic symptom is "deposit of red sediment 
which adheres to the chamber and is removed with 
difficulty." Lycopodium has also a red deposit, 
but it is granular like sand. The deposit of Can- 
tharides is granular but is grayish white, looking 



KREASOTUM. 



like fragments of old mortar. (Of course it is to 
be remembered that besides these deposits, both 
Lycopodium and Cantharides, as well as Dulca- 
mara and Cannabis and Hepar may present — and 
be indicated where there exist — deposits of mucus, 
pus and blood.) 

In women, Kreasote has a discharge of bland, 
yellow leucorrhcea preceding each urination, with 
frequent desire to urinate. 

Female Sexual Organs. Much excitement is 
produced. There are pains in the pudenda ; stitches 
in the vagina proceeding from the abdomen. Intol- 
erable itching in the vagina ; the labia swell and 
become excoriated ; and in this condition smart 
exceedingly during and after urination, which is 
frequent. The leucorrhceal discharge is very acrid, 
excoriating the parts which it touches. The men- 
ses come too soon and are too copious, the flow 
being dark and thick. It is followed by leucor- 
rhcea and by the local symptoms just described. 
The menses are accompanied by many accessory 
symptoms, e. g., nausea, deafness, and abdominal 
colics. The menstrual flow often ceases on the 
third or fourth day, and after a few hours, or a 
day, re-appears. In this respect Kreasote resem- 
bles Sepia, but the flow of Sepia is scanty and 
retarded, while that of Kreasote is abundant and 
anticipates ; and the local symptoms and general 
condition of Sepia are less pronounced, or decid- 
edly different. 



KREASOTUM. 



167 



The menses are followed by leucorrhoea, which 
is at first very acrid and dark brown in color, and 
quite offensive. Nitric acid has a dark flesh-col- 
ored discharge after the menses, but it is thin and 
watery, looking like the washings of meat, and it 
is not offensive. 

In a day or two the leucorrhoea of Kreasote 
becomes deep yellow, and has a peculiar odor, like 
that of fresh green corn when it has just been 
husked. 

Along with the leucorrhoea there is much pain 
in the back, a dragging pain from above down- 
ward, a pain as if something would come out, or 
as after long stooping. This pain is relieved by 
motion and is worse during rest; just the opposite 
of the backache of Sepia and Nux vomica, and 
similar to that of Belladonna. 

These series of symptoms have led to the use 
of Kreasote in prolapsus uteri, in which it has 
proved of great value. Along with Sepia, Pulsa- 
tilla, Stannum, Nux vomica, Belladonna and Podo- 
phyllum, it enables us to avoid altogether the use 
of those miserable make-shifts, pessaries and sup- 
porters, which, affording temporary relief, entail so 
great miseries on those who use them. 

The Kreasote cough is noteworthy. It is spas- 
modic and fatiguing and wheezing, excited by 
a sensation of a crawling below the larynx, or as 
from mucus in the bronchi which cannot be dis- 
lodged. 



KREASOTUM. 



There is a copious expectoration of thick, 
yellow mucus. Along with the cough heaviness 
upon the chest with dyspnoea, as though the chest 
were bruised on inhalation. Pain as though the 
sternum would be crushed in, with stitches here 
and there. These symptoms have led to the suc- 
cessful use of Kreasote in "nervous asthma." 

Lassitude in the limbs, and numbness of the 
fingers. 

The present general use of carbolic acid may 
give us new symptoms. 



SECALE CORNUTUM. 

ERGOTc SPURRED RYE. MUTTERKORN. 



METAMORPHOSIS of rye, or other grain, 



l\. by which it is converted, wholly or in part, 
into a curved, purplish-black, cylindrical, tapering 
and grooved excrescence, from one to three lines 
in diameter, and usually from six to ten lines long. 
When dry it is firm and brittle, but when moist 
is soft and flexible. It gives out a sickening, 
heavy smell. Its color externally is purplish black. 
Internally it is pinkish white. It has a nauseous 
and slightly acrid taste." 

It is said to be more active if gathered while 
the grain is still standing, about harvest time, than 
if collected after harvest. 

It appears from the popular German name of 
this substance that it has been in domestic use as 
a parturifacient from early ages. So it certainly 
was in France. Indeed, its use as such in France 
was interdicted in 1774. 

Still, it was ignored by physicians until Dr. 
Stearns of Waterford, N. Y., introduced it in 1807 
as "a substance which he had used for several 
years to expedite lingering labors when the pains 




1 70 



SECALE CORNUTUM. 



had subsided, and were incompetent to expel the 
fcetus." Since that time it has been more cr less 
generally used in lingering labors. It is well 
understood that its power to cause violent contrac- 
tions of the muscular fibres of the uterus, is so 
great that it should never be given when the os 
uteri is not fully dilated, nor unless there be satis- 
factory evidence that no mechanical obstacle inter- 
feres with the completion of the labor ; otherwise, 
there is great danger of death of the fcetus from 
violent compression, or of rupture of the uterus 
from the same cause. 

It is justly regarded as unfortunate if the labor 
do not come to an end soon after the administra- 
tion of the Ergot, since if it be delayed there is 
reason to believe that the child will be poisoned 
by it. 

Ergot is used in the forms of infusion, tincture, 
wine, trituration, and watery extract. 

Its effects on the lower animals are as follows : 
The pulse is lessened, the action of the heart 
becomes irregular, the breathing slow and deep, 
appetite and flesh fail ; tremulousness, staggering 
and dullness come on. Haemorrhage of black 
blood from the nostrils, bowels or vagina occurs, 
then diarrhoea and death ensue. Moreover, it 
acts uniformly in a greater or less degree upon 
the gravid uterus, causing abortion or premature 
delivery, and, not infrequently, death of the fcetus. 

On man, in small doses, not often repeated, 
it is said to have produced colic, nausea and vom- 



SECALE CORNUTUM. 



171 



iting, salivation and diarrhoea. Depression of the 
pulse always results from its use. 

These poisonous effects are said to be due to 
the oil of the Ergot, which, if given alone to a 
parturient woman, does not cause contraction of 
the uterus, but does poison the foetus. Whereas, 
on the other hand, the Ergot, deprived of its oil, 
acts on the uterus, but does not poison the foetus. 

These statements should be taken cum grano 
salts. 

In certain districts and throughout some coun- 
tries, Poland in particular, the grain has at certain 
periods been so completely ergoted that the 
nutriment of the entire population has been more 
or less contaminated with this poison. Hence 
have arisen epidemics of a malady called ergotism. 
One of the earliest dates 1096. Ergotism is of 
two kinds, spasmodic and gangrenous. 

The spasmodic is ushered in by a general 
feeling of illness. Then follow formication of the 
whole skin, cramps and numbness of the extrem- 
ities, and pains in the head and back. After a 
few weeks occur heart-burn, vertigo, syncope, deaf- 
ness, paroxysmal or permanent curvature (flexure) 
of the joints, and equally violent extension and 
opisthotonos, twitching of the facial muscles, some- 
times violent delirium with cold skin, intense inter- 
nal heat, and foetid sweat. These attacks last 
several hours. 

After a while the convulsive aspect of the dis- 
ease ceases. It is followed by exhaustion, debility, 



1 72 



SECALE CORNUTUM. 



oppression, heart-burn, and a ravenous appetite, 
which it is dangerous to gratify. Sometimes stra- 
bismus or loss of sight succeeds, with general 
insensibility of the skin. After death the stomach 
and bowels are found inflamed and the parenchy- 
matous organs congested. It generally proves fatal 
in three or four weeks. It is very fatal. 

The gangrenous form is very different. It com- 
mences with dull pain and weariness of the limbs, 
with heaviness and stupidity of the face. The skin 
acquires an earthy or jaundiced hue. The extremity 
about to be affected (sometimes it is the nose) 
becomes cold, and the skin over it gets dusky 
red. Then gangrene begins in the inside of the 
end of an extremity (or of the nose) and extends 
outward to the skin. It also extends upward 
toward the trunk. The parts affected shrivel, dry 
up, become black and harden until they look like 
those of a mummy. They separate from the living 
flesh without haemorrhage and by a clean line of 
division. Death is sometimes preceded by diar- 
rhoea. Beside weakness, there is not much eeneral 
disturbance. The cases run their course in about 
three weeks, and are almost always fatal. 



ANALYSIS. 

To describe more particularly the more charac- 
teristic symptoms of Secale, we may mention : 

1. General numbness and formication over the 
whole body. 



SECALE CORNUTUM. 



I 73 



2. The disposition is exceedingly melancholy, 
and depressed, with apprehension and dread of 
death. There is also violent mania. 

3. Vertigo and stupefaction ; dull headache. 

4. Dilatation of the pupils, the eyes stare. 
There is double vision, squinting, obscuration of 
the sight. 

5. Humming and roaring in the ears. 

6. The face is pale and sunken. The com- 
plexion is earthy and sallow. 

7. The voice becomes feeble. Speech is slow 
and difficult and inarticulate. There is tingling in 
the tip of the tongue, which is stiff. 

8. Bleeding from the nose ; dark blood is dis- 
charged. . 

9. Appetite gone. 

10. Eructations, heart-burn, vomiting. Constant 
retching and oppression. Burning in the stomach. 

11. Coldness in the back and abdomen. Burn- 
ing in the abdomen. 

12. Painful diarrhoea, with great prostration. 
Involuntary diarrhoea; putrid, watery, fetid, brown, 
profuse diarrhoea, with great exhaustion ; a sudden 
change of the expression of the face, sinking of 
the eyes, etc., etc., as in cholera ; suppression of 
the urine, etc. 

13. Diminution and suppression of the urine. 

14. The menses too profuse and too soon. 
Metrorrhagia, the blood being very liquid, but dark 
and attended by formication. Labor-like pains. 

15. Weakness of the extremities. Formication. 
Convulsions. Rigidity. Gangrene. 



1 74 SECALE CORNUTUM. 

PRACTICAL USES. 

1. In lingering labors, where no obstruction ex- 
ists, it is in common use. The infusion is preferred. 
Two drachms of pulv. Ergoti in eight ounces of water. 
The dose is two drachms every five minutes. The 
objections are its bad effects on the child. Hence 
the rule not to use it except where labor may be 
expected to end within a short time after giving it. 

I prefer the Dublin mode of using the forceps 
early. In homoeopathic practice, Ergot is generally 
superseded by Pulsatilla or Nux vomica. 

2. In uterine haemorrhage, whether as a sequel 
of abortion or labor, or an independent Occurrence, 
or a concomitant of cancer, etc. It is character- 
ized by the blood being dark and liquid, and by 
the general symptoms, especially the formication. 
It is used by allopaths to bring on abortion, pro- 
voking haemorrhage ; yet Gardner recommends it 
to arrest abortion begun from other causes ! 

In Asiatic cholera, Ergot has been used with 
success. 

In diarrhoea, fetid, brown, watery, passing invol- 
untarily, or nearly so, it is a most valuable remedy. 

In cancer uteri it arrests haemorrhage and relieves 
the terrible burning pains at night which torment the 
patient. This it does in small doses, even the 200th. 

In paralysis, and particularly in paraplegia, as 
well as in dry gangrene, Secale should receive 
greater attention than is generally accorded to it. 



JUNIPERUS SABINA. 



SAVINE. 



N evergreen shrub of South Europe. The 



l\ leaves and tops are used in medicine. 
Their properties depend on an essential oil, which 
dissolves in alcohol. 

It was used by the ancients to stimulate indolent 
ulcers, to hasten the menses, and to cure chronic 
gout and rheumatism. Also to induce abortion. 

It is described by allopathic writers as the most 
powerful emmenagogue of the materia medica, and 
also (!) as the best remedy for unduly abundant 
menstruation and threatened abortion ! M. Aran 
says : " Strange as it may appear, this powerful 
emmenagogue has the power of suspending uterine 
haemorrhage ! " 

Time fails me to enter upon a more minute 
analysis of Sabina than that of the uterine system. 

It produces copious and early menstruation. 
Likewise metrorrhagia, and it is characteristic that 
the flow is paroxysmal and of a very bright color. 
It is always attended by pains in the joints. 

It produces leucorrhcea, with itching irritation. 




i ;6 



JUNIPERUS SABINA. 



Besides cases of uterine haemorrhage character- 
ized thus, cases of threatened abortion have been 
cured by Sabina. 

It is useful (symptoms corresponding) in pro- 
tracted uterine haemorrhages at the "change of 
life." 



ACHILLEA MILLEFOLIUM. 



MILLEFOIL. YARROW. 

THIS wayside drug produces haemorrhage from 
all the mucous surfaces. The haemorrhage is 
painless, and the blood very light colored and fluid. 

In painless drainings from the uterus (or nose 
or lungs) after labor, after abortion, or when an 
abortion threatens, if the blood be bright and there 
are no pains in the joints, Millefolium does good. 
So sometimes it checks too profuse menstruation. 



IT— 13 



ARSENICUM ALBUM. 



METALLUM ALBUM. ARSENIOUS ACID. 

HIS substance is generally prepared by subli- 



X mation from the ores of cobalt, and is often 
found adulterating the ores of zinc. It is a white 
powder, completely soluble in boiling water. It has 
neither taste nor smell, but leaves a somewhat acrid 
sensation on the fauces ; and when fused and thereby 
deoxidized, it emits the odor of garlic which char- 
acterizes the heated metal. 

In medicine, the forms of Arsenicum chiefly used 
are the arsenious acid and the solution of the 
arsenite of potassa known as " Fowler's solution," 
or the "tasteless ague drop." The latter- is pre- 
pared by dissolving equal parts of arsenicus acid 
and carbonate of potassa in boiling distilled water. 
A very little compound spirit of lavender is added 
to give color and flavor. It contains four grains 
of arsenious acid to the fluid ounce. 

Dose : Five to twenty drops ; it may be repeated 
several times daily. 

Arsenious acid has been known since the eighth 
century. In the fourteenth century, it was used as 




ARSENICUM ALBUM. 



179 



a medicine in the treatment of diseases of cattle. 
In the seventeenth and eighteenth centuries, it was 
used as a caustic application to malignant ulcers, 
but its use was condemned by regular physicians. 
Irregular practitioners, however, had learned its 
value in the treatment of skin diseases and of 
intermittent fever. How they found this out is 
more than we can say. 

The same has been true of nearly every drug 
of the materia medica. It is certain, however, that 
while in irregular and domestic practice intermit- 
tents and skin diseases were being cured by Arsen- 
icum every day, its use was condemned by the 
faculty; and Goeffroy said, "Though it may be a 
good remedy for the present, it will afterward 
prove a poison and bring on very dismal symptoms. 
Arsenic, therefore, is, in my opinion, worse than the 
fever ! " 

Not so, however, thought the patients who were 
glad to get rid of their fevers, and to run the risk 
of the dismal symptoms. The popularity of the 
remedy, and its extensive use, unsanctioned by the 
faculty, at length converted learned doctors ; and 
Arsenic was received into the orthodox pharma- 
copoeia, and became forthwith " a safe remedy," and 
much better " than a fever itself." 

Arsenic is a poison to plants as well as to 
animals. 

Upon animals it acts in its well-known peculiar 
way, however it be introduced into the system, 
whether by the stomach or by the rectum, or 



i8o 



ARSENICUM ALBUM. 



through the external surface of the body by the 
endermic method. Cases of fatal poisoning are 
on record in which the arsenic was introduced 
in a wash applied to cutaneous eruptions or 
to ulcers. 

The fumes of arsenious acid act very sensibly 
on the system. It is recorded that persons have 
been poisoned by inhaling the air of a room in 
which had been burned candles the wicks of which 
had been saturated with a solution of arsenious 
acid. The same result has followed the use of 
arsenious acid in candles to harden them. Clay 
tobacco pipes are glazed with a preparation of 
arsenious acid, — at least those having a superior 
finish, and designed for the use of the aristocracy. 
At the first smoking this glazing is volatilized, and 
the smoker inhales a dose of arsenic. Every new 
pipe involves a new dose. Some persons scorn to 
use any but a new pipe. Fatal poisonings have 
resulted from this fastidious extravagance. 

A beautiful green wall-paper gets its color from 
the arsenite of copper, a pigment known as 
Scheele's green. The exhalations from this paper 
have caused illnesses and death. The same pig- 
ment is used in almost every form of ornamenta- 
tion of dress and furniture and condiments, from 
the artificial flowers of the fine lady's head-dress, 
which give her the mysterious arsenical neuralgic 
headache, to the green candy toy of her spoiled 
child, which, when eaten, gives the child the equally 
mysterious arsenical stomachache. 



ARSENICUM ALBUM. 



181 



The effects of small closes of arsenic frequently 
repeated, producing chronic arsenical poisoning, are 
thus described : 

" Loss of appetite, nausea, deranged digestion, 
diarrhoea, thirst, salivation, tenesmus, colic and 
intestinal cramps ; respiration labored and painful ; 
a sense of oppression with pain in the breast ; 
cough ; extreme wasting of the flesh, and hectic 
fever ; the limbs grow tremulous, and not unfre- 
quently are paralyzed, especially the lower extrem- 
ities ; pains in the whole body, but particularly in 
the hands and feet ; stiffness and contraction of the 
extensor muscles succeed ; numbness invades the 
extremities, and the mental faculties subside into 
insensibility and torpor ; oedema of the face and 
extremities, and even general anasarca are not 
unusual ; the hair falls out ; epidermis scales off ; 
pustular and other eruptions, ending in ulceration, 
attack the skin, which acquires a lifeless, earthy 
hue ; the countenance, if not cedematous, is sunken ; 
the conjunctiva is strongly injected, and a reddish 
circle surrounds the eyes." 

The symptoms of acute poisoning are as follows : 

" Immediately after the poison is swallowed a 
metallic taste is perceived, with constriction of the 
fauces. A violent burning pain, which soon becomes 
excruciating, is felt in the stomach, and gradually 
extends itself over the whole abdomen, steadily 
increasing in severity until it becomes intolerable. 
Retching and vomiting and cramps of the bowels 
ensue, with spasms of the oesophagus and chest, 



182 



ARSENICUM ALBUM. 



which resemble those of hydrophobia. The thirst 
is insatiable, but even the mildest drinks cannot be 
retained. The tongue is generally fissured, hard 
and dry, although occasionally there is profuse sali- 
vation, and the voice is hoarse. There is also 
tenesmus, with bloody and offensive stools and 
retraction of the abdomen. The irritation extends 
to the urinary organs, producing strangury. Some- 
times the urine is completely suppressed, and 
sometimes it is mixed with blood. Christison says 
that in women there is burning in the vagina and 
excoriation of the labia, but this does not happen 
unless life is prolonged beyond three days. Bach- 
man had previously noticed the pain above alluded 
to, and* also profuse menorrhagia among the symp- 
toms in women. 

"The pulse is irregular, rapid and intermittent; 
the muscles are spasmodically affected ; the skin 
presents a livid eruption, as already described. 
The sense of anguish 'is unutterable, and sometimes 
there is delirium. The breathing is oppressed. A 
consuming fire seems to prey upon the vitals, 
while the whole body is pale, cold, shivery and 
clammy. The features are sunken and sharp ; if 
vomiting occurs it is convulsive and affords no 
relief. Exhaustion of mind and body; prostration 
and despair, with anxious restlessness, generally 
attend this stage of the attack. On the approach 
of death, spasm yields to general exhaustion, 
the pulse grows slow and feeble, and urine and 
faeces are passed involuntarily, but sensibility and 



ARSENICUM ALBUM. 



consciousness are lost only in the last moments 
of life 

"The duration of the symptoms is variable, and 
may be stated, in general, as from six to twelve 
hours, but occasionally they last several days. 

" But even when recovery from the acute symp- 
toms takes place it is rarely complete. For months 
or even years, the joints remain stiff and swollen, 
rendering walking difficult and painful ; the digestive 
organs continue irritable and feeble, and all the 
functions of the nervous system are impaired. In 
some cases paralysis of the upper or lower extrem- 
ities occurs, and gangrenous ulcers attack the legs." 

"The quantity of arsenious acid sufficient to 
cause death will depend," says CEsterlein, "on the 
condition of the stomach at the time the arsenic is 
swallowed. If the stomach be full of food at the 
time a large quantity may produce only a slight 
effect." Thus CEsterlein reports a case in which 
just after a hearty meal a man swallowed a quarter 
of an ounce. Emetics were given immediately and 
no evil followed. 

On the other hand, very small doses may pro- 
duce very violent and fatal symptoms. 

Four, three, and even two grains of arsenious 
acid have destroyed life. 

A summary review of the effects of Arsenic 
leads us to conclude : 

i. From the fact that, after death from poi- 
soning by it, it is found in almost every tissue 
and secretion of the body, that it is universally 



184 ARSENICUM ALBUM. 

diffused throughout the body and acts upon every 
part. 

2. From the fact that its action and diffusion 
are uniform, however it be introduced into the 
body, whether through the skin or by the alimen- 
tary canal, that its action is specific and not local. 

3. From its effects in chronic poisoning, pro- 
ducing anaemia, exhaustion, emaciation, etc., that 
it acts upon the blood composition, as well as 
directly on the tissues and on the nervous system. 

We consider now the more intimate specific 
effects as gathered from provings on the healthy 
body, made by Hahnemann and his pupils. 

A few words from Hahnemann's introduction 
to his proving may not be amiss, and especially 
since the use of Arsenic as a remedy has been 
denounced on the ground of its frequent abuse as 
a poison. \ 

"When I utter the name Arsenic, powerful 
recollections possess my soul. 

"In creating Iron, the All- Merciful left it free 
to His children to transform it at their pleasure, 
either into the murderous dagger or the blessed 
ploughshare, and to use it either for destruction or 
preservation. * * * * 

" It is not the fault of Him who loves us all 
that we abuse powerful medicinal agents, giving 
them either in too large doses or in cases for which 
they are not suitable, being merely guided by the 
caprice of miserable authorities, and without having 
taken the trouble to investigate the inherent cura- 



ARSENICUM ALBUM. 



I8 5 



tive virtues of the drug, and to make our selection 
depend on the knowledge thus obtained." 



GENERAL ANALYSIS. 

i. Arsenic exhausts the vital power of certain 
organs or systems or of the entire organism, pro- 
duces symptoms of impeded activity in the func- 
tions of organs ; indeed, in some cases, positive 
paralysis. 

This asthenic condition characterizes the entire 
symptomatology of Arsenic. For this reason, the 
sensations of prostration, lassitude, weakness, etc., 
sinking of the forces, etc., are highly characteristic 
indications for Arsenic. They are so peculiar to 
Arsenic that Hahnemann says: "Even circumstances 
that are in themselves not very important and would 
otherwise produce but little effect, occasion in the 
Arsenic patient a sudden and complete sinking of 
the forces." This is a vital phenomenon and not a 
result of chemical or physical destruction of vital 
organs, as the stomach or intestine ; for this sink- 
ing occurs when there is no such destruction. 

2. The organic substance of the body is acted 
upon throughout. A cachectic dyscrasia and colli- 
quative destruction of tissues is indicated by 
symptoms of the complexion, excretions, ulcers, 
eruption, and the skin generally. 

Hence the use of Arsenic in persons of a 
cachectic habit, in leucophlegmatic persons. 



i86 



ARSENICUM ALBUM. 



3. The sphere of action embraces almost all 
the organs and systems of the body, but it acts 
especially on the mucous membranes and the exter- 
nal skin. 

4. It is one of the most eminent periodics of 
our materia medica. 

5. As characteristic peculiarities may be men- 
tioned : 

That the symptoms of Arsenic are almost always 
accompanied by great restlessness and anxiety, 
indeed sometimes by frantic desperation. 

That they are sometimes relieved for a time 
by external warmth. 

That they occur and are aggravated during 
repose, but are ameliorated by standing and by 
mo vino-. 

That the symptoms are almost always attended 
by concomitant symptoms ; that is, by symptoms 
which stand in no pathological relation to the 
former. 

That as regards the time of day at which the 
symptoms occur or are aggravated there is a great 
variety. Most of them occur at night after lying 
down, or about two a. m. ; some on rising, and after 
dinner. 

SPECIAL ANALYSIS. 

The action on the head is not very striking. 
Pressing pain and semi-lateral headaches are 
mentioned by provers, but not graphically. It is 



ARSENICUM ALBUM. 



I8 7 



probable that the general symptoms alone will suf- 
fice to guide the prescriber in selecting Arsenic for 
headache. 

Eyes. Upon the eyes and their appendages 
Arsenic produces : itching, drawing and pressure 
around the eyes, swelling of the lids, pains on 
moving the eyelids, as if they were dry and rubbed 
against the eyeball ; agglutination of the lids ; 
increased lachrymation ; drawing and pressure, but 
especially tickling, itching and burning (the charac- 
teristic sensation produced by Arsenic.) The con- 
junctiva is reddened, there is photophobia, the 
pupils are contracted ; in fact there is every symp- 
tom of inflammation. As regards vision itself, it 
is obscured and weakened. 

With regard to the ears, no symptom seems 
characteristic, except that, almost all the paroxysms 
of pain, wherever located, begin with roaring in 
the ears. But when it is remembered that great 
debility and exhaustion attend the pains of Arsenic, 
and that these in turn are apt to be attended by 
roaring in the ears, this symptom will not be 
regarded as indicative of a special affection of the 
ear. 

Let me, however, caution you against supposing 
that because Arsenic has hitherto produced no defi- 
nite ear affection it cannot nevertheless cure one. I 
shall have occasion to relate to you a severe case 
of otalgia, cured in a very short time by a single 
dose of Arsenic ; which was indicated by the gen- 
eral constitutional symptoms of the case. 



i88 



ARSENICUM ALBUM. 



The face is altered in complexion, which assumes 
a sunken, yellow, ghastly aspect ; the skin around 
the mouth is livid, the face is cold and sunken. 

Swelling and inflammation of the lips, bleeding 
of the lips, painful tumor in the lip, an ulcer, 
phagedenic, with a tearing, biting, burning pain, 
aggravated by touch, and in the air, and especially 
at night. These symptoms must be remembered 
in connection with the well-known and long-known 
use of Arsenic in ill-conditioned ulcers of the lip, 
lupus, and epithelial cancer. 

The toothache of Arsenic is a pressing, tearing, 
jerking, not infrequently conjoined with swelling 
of the cheek, relieved by sitting up in bed, and 
by external warmth. Many other remedies produce 
the same effects. The indication for Arsenic must, 
therefore, be drawn rather from the constitutional 
than from the local symptoms. • 

Arsenic produces great dryness of the mouth 
and excessive thirst, yet at the same time the prover 
drinks but little at a time. The saliva is sometimes 
bloody. The tongue is dry as if burnt, deprived 
of sensibility, stitching pains in the root of the 
tongue, burning pain in the tongue. 

The tongue is excoriated at the tip, which has 
a biting or burning pain. 

In the throat, dryness and burning, a scraped, 
ulcerative sensation. Constrictive feeling in the 
oesophagus and throat. Gangrenous inflammation 
of the throat. 

Action on the fauces is eminently exerted by 
Arsenic, however it be introduced into the system. 



ARSENICUM ALBUM. . 189 

The same may be said of its action upon the entire 
alimentary canal. 

Arsenic alters the normal taste ; sometimes this 
is extinguished. Again, the taste is bitter, sour, or 
putrid. Appetite is abnormal ; there are cravings 
for acids, for coffee, etc., but especially loss of 
appetite ; there is nausea at the idea of food. 

The nausea which Arsenic produces is conjoined 
with a sensation of the greatest weakness, with 
anxiety ; it recurs periodically. It is often con- 
joined with symptoms that seem to have no patho- 
logical connection with it ; it is worse during repose, 
and is aggravated by motion. 

Actual vomiting occurs, with great anxiety, with 
diarrhoea, with severe griping and burning pains in 
the stomach and abdomen. 

The vomiting requires great effort; is scanty in 
quantity, as are all the excretions of Arsenic ; and 
it is followed by extreme prostration. 

The matters vomited may be first water, then 
thick, glairy or grass-green mucus, and then blood. 
The stomach becomes at times so irritable that it 
will net tolerate food. 

Hahnemann says, Arsenic provokes in the stom- 
ach rather an irregular convulsive action than an 
ordinary peristaltic or anti-peristaltic motion ; rather 
an anxious, fruitless retching than a copious vomiting. 

In the stomach itself, pressing, gnawing, burn- 
ing, and a feeling as though the stomach were 
distended. 

The burning pains are the most constant. 
With them come violent thirst, lamentation, anguish. 



ARSENICUM ALBUM. 



They may be continuous or periodic. If the latter, 
they occur most frequently at two a. m., or after 
eating. 

Intestines. All the varieties of pains analogous 
to that which is so characteristic of Arsenic, viz. : 
burning, may be confined to single parts of the 
abdomen, or may be general, — generally in the 
hypogastric region, — accompanied by thirst, rest- 
lessness and the other conditions of Arsenic. 

Stool. Most important symptoms. 

Arsenic produces diarrhoea ; it is our most 
important remedy for diarrhoea. As all the excre- 
tions of Arsenic are scanty, so is the stool. The 
irritation is disproportionately great. The stool is 
preceded by restlessness, anguish, and pain in the 
abdomen. It is accompanied by vomiting, excessive 
pain in the abdomen, burning in the rectum, tenes- 
mus. It is followed by burning in the anus, 
palpitation, trembling of the limbs, great weakness 
— out of all proportion to the amount of stool. 

It is of great importance to note the concomi- 
tant symptoms that precede, accompany and follow 
the stool. They often indicate the remedy. Thus 
Nux vomica, Mercury, Aloes, Capsicum, Podophyl- 
lum, Veratrum and Phosphorus are distinguished. 

The stool, as regards its character, is diarrhceic. 
It consists of a pappy (not often watery), yellow, 
bloody or greenish, or more frequently a blackish, 
very offensive substance. 

The characteristics may be said to be small 
quantity, dark color, offensive odor ; great prostra- 
tion following it. 



ARSENICUM ALBUM. 



I 9 I 



No other drug combines all these character- 
istics. Phosphorus has some ; but Phosphorus is 
never indicated where the loss of power, the 
prostration, is a striking symptom. 

Veratrum has some, but the quantity of the 
excretion is as remarkably large, as, under Arsenic, 
it is notably small. 

Secale cornutum has some, but the stool is 
watery, putrid, dark brown ; and there is not the 
restless anguish of Arsenic. 

Graphites has some, but the stool is pasty, of 
a light brown color, and a most atrocious odor, 
with scarcely any pain, and no restlessness, nor 
weakness, etc., etc. 

There is burning in the bladder and in the 
urethra. The urine is scanty. Three cases of 
chronic poisoning, — recorded in the "Edinburgh 
Medical and Surgical Journal," — one from which 
the patient recovered, two in which death occurred, 
present us perfect pictures of Bright's disease, even 
to the pathological anatomy of the disease. 

Arsenic produces a , yellow, acrid leucorrhcea, 
and increases the menstrual flow. 

During the menses, sharp sticking in the rec- 
tum, extending to the anus and pubes ; cutting 
pains in the abdomen, with the conditions charac- 
teristic of Arsenic. 

The menses are often followed by a discharge 
of bloody mucus. 

. It should be added, that, in cases of chronic 
poisoning, profuse metrorrhagia has occurred ; and 
this fact has led to the successful use of Arsenic 



192 



ARSENICUM ALBUM. 



in such cases, where the constitutional symptoms 
correspond. 

Arsenic seems to produce in the mucous mem- 
brane of the respiratory organs a hyperaemic and 
inflammatory condition, the symptoms of which vary 
according to the locality. 

Thus, in the nasal membrane, the irritation is 
shown by frequent sneezing, by obstruction alter- 
nating with fluent coryza, with hoarseness and 
drowsiness ; the nares burn, and the discharge is 
watery and very acrid. 

On the larynx, the action is not marked. But 
we have constant tickling in the entire trachea, 
which provokes a cough, a feeling of rawness, 
soreness and burning in the chest ; scanty, tena- 
cious mucus in the chest, hard to dislodge ; and 
when dislodged it is blood-streaked. 

The cough is dry, and very fatiguing. It is 
paroxysmal, worse at night ; and is sometimes so 
violent that it seems as though suffocation would 
ensue. It is aggravated by drinking, by movements 
of the body, and by the open air. 

But the cough symptoms, etc., are by no means 
so violent, nor indeed so significant, as those of 
several other remedies. On the other hand, Arsenic 
produces a series of chest symptoms very peculiar 
and significant, viz., the asthmatic series. 

Constriction of the chest (here we meet the 
characteristic constriction, as in the oesophagus, the 
rectum and the bladder), dyspnoea, asthma, whis- 
tling respiration — indeed all degrees of difficult 



ARSENICUM ALBUM. 



193 



respiration, dyspnoea, orthopncea, apnoea. They may 
be paroxysmal, intermittent, periodically recurring, 
worse at night. 

Burning- in the chest. 

The heart is especially affected by Arsenic, and 
it is probable that some of the dyspnoea is thus 
explained. 

We find anguish in the praecordia, stitching and 
sore pain there on coughing ; pain under the prae- 
cordia restricting respiration ; .palpitation ; at night, 
about three a. m., an irregular but very violent 
palpitation, which seems to him audible, with great 
anguish ; palpitation much worse when he lies on 
the back. 

Pathologico-anatomical investigations show the 
heart to be " lax, not over-filled with blood, the 
muscular substance infiltrated with blood. The 
pericardium contains serum." It would appear that 
Arsenic affects the muscular substance of the heart. 

In the trunk, Arsenic produces various pains 
of stiffness, lassitude and powerlessness. 

Autopsies show that the spinal marrow is always 
affected, especially the lower part of it. 

In the upper extremities (as might be supposed) 
the symptoms are few, chiefly those of loss of 
power. 

In the lower extremities they are numerous, 
but may be reduced to three varieties : pain, spasm, 
paralysis. 

The pains are stitching, boring and tearing. 
The spasms are generally tonic contractions. The 
II.— 14 



194 



ARSENICUM ALBUM. 



paralysis occurs, generally, in fatal cases, not long 
before death, and is hardly a specific effect of 
Arsenic, but rather a forerunner of dissolution. 

The skin is one of those organs on which the 
action of Arsenic is most powerfully exerted. 

Thus Arsenic produces: r. Pains, itching, biting, 
gnawing ; but above all, burning. 

2. Watery swellings ; from puffiness of the feet 
or the face to general anasarca. 

3. Eruptions. Inflamed spots on the face, head 
and neck ; nettle-rash, yellow spots. 

Whitish papules or elevated spots, itching and 
burning, like lepra, red pimples, pustules. 

4. Soreness between the arms and trunk. 
Ulcers already existing and hitherto painful become 
very sensitive, as if red-hot coals were laid upon 
them ; the margins become elevated, and they 
bleed, discharging black blood ; the ulcers become 
offensive. 

The sleep is disturbed ; sleeplessness alternates 
with restlessness and tossing, twitching and jerk- 
ing. There are vivid, anxious dreams. Sleep does 
not refresh. 

The fever may be continued, or remitting, or 
distinctly intermittent; quotidian, or quartan. 

The paroxysm is not complete. One stage is 
generally wanting. 

The fever is most apt to occur at night. 

The sweat occurs only at the end of the fever, 
or only at the beginning of sleep. 

The pulse is small ; quick, but weak. 



ARSENICUM ALBUM. 



!95 



Thirst never accompanies the chill, but comes 
after it. It does not accompany the night fever, 
but is very violent during the sweat. 

The disposition is : 

a. Depressed, melancholy, despairing, indifferent. 

b. Fearful, restless, anxious, full of anguish. 

c. Irritable, sensitive, peevish. 

PRACTICAL APPLICATIONS. 

Masked ague. Otalgia. Neuralgia. Bright's 
disease. Dyspepsia. Diarrhoea. Metrorrhagia. 
Skin diseases (psoriasis). Intermittent. Coryza. 
Asthma. Chorea. Heart disease. Ulcers. 

The fact cannot be too often called to mind, 
nor too strongly insisted upon, that our most 
characteristic indications for the use of a drug 
which presents well-defined general symptoms, as 
Arsenic does, and indeed as every well-proved drug 
does, are derived not from its local action upon 
any organ or system, not from a knowledge of 
the particular tissues it may affect, and how it affects 
them, but upon the general constitutional symptoms 
and their conditions and concomitants. If this were 
not so, in the presence of how many maladies, of 
the intimate nature of which we are wholly igno- 
rant and which nevertheless we cure, should we be 
utterly powerless for good. 

I mention and urge this, because the opposite 
is strongly presented by an author whose volumi- 



I96 ARSENICUM ALBL'M. 

nous productions are evidence in themselves of the 
notorious fact that his life has been that of a stu- 
dent and compiler; that he entirely lacks the 
practical experience in the treatment of the sick, 
which serves as the test and corrective of any- 
theoretical opinions we may form of the mode of 
selecting drugs, and of their mode of action. 

A few cases will illustrate what I mean. 

A lady of middle age suffered from intense 
pain in the inner ear. There were no indications 
of external inflammation. The pain had lasted 
several days. No remedy had given any relief. 
Morphine had only temporarily assuaged the pain, 
which afterward became worse again. Here was 
the case. What organ was affected ? Doubtful. 
What tissues ? Who could say ? Could Arsenic 
be the remedy ? Certainly Arsenic produces no 
such symptoms. What were the constitutional 
symptoms and the conditions ? Did the patient 
endure the pain patiently ? On the contrary, the 
pain was intolerable. Her whole demeanor indi- 
cated positive anguish. She could not retain one 
position for more than a few seconds, but tosted 
and moved about, and was constantly changing her 
posture. Then, the pain was not constant. 

It intermitted, the intervals varying from ten 
to ninety minutes. 

As regards character, the pain was described as 
a fine, burning pain. 

The effects of the pain were very remarkable. 
Whereas during its continuance the patient's vio- 



ARSENICUM ALBUM. 



197 



lent movements indicated the possession of no 
inconsiderable muscular vigor, no sooner had the 
paroxysm passed over than she fell into a state of 
really pitiable exhaustion and weakness. Moreover, 
she had burning thirst, though she cared to drink 
but little at a time. 

Here, then, we have, though none of the local 
symptoms corresponded to Arsenic, yet a complete 
picture of the general or constitutional action of 
that drug. We have burning pain, intolerable 
paroxysmal pain, followed by disproportionate 
exhaustion, and attended by burning thirst, in 
which, however often the patient drinks, she takes 
but little at a time. A single dose of Arsenic 3 °, 
given at the commencement of a paroxysm of pain, 
caused the disappearance of the pain in the space 
of five minutes. The patient fell asleep. There 
was never any return of the pain. She was well. 

A second case will serve to illustrate not merely 
this point but also another, viz. : the detection and 
treatment of what is sometimes called " masked 
intermittent ; " by which is meant a disease clearly 
resulting from marsh-malaria, and which neverthe- 
less does not manifest itself by the customary 
paroxysm of chill, heat and perspiration, which 
constitute intermittent fever. 

A precocious child in Dutchess County, twelve 
years old, had complained for more than eighteen 
months of a severe pain in the left ear. She was 
brought to my office for treatment, with the state- 
ment that for this affection she had been treated, 



198 



0 

ARSENICUM ALBUM. 



both locally and constitutionally, for an inflammation 
of the middle ear, by some of the most distin- 
guished surgeons of the city of New-York, but with 
no good result. I could discover no distinct signs 
of local lesion, but nevertheless supposed it to be 
a case of otalgia, and from a very close corre- 
spondence of the case, as described to me, with the 
symptoms of Chamomilla, gave that drug. 

She got no better. I then learned that she 
had been under the care of a good homoeopathic 
physician, who, if it had been simple otalgia, would 
surely have cured her. This fact induced me to 
scrutinize the case very carefully before I prescribed 
again. Visiting the patient repeatedly at her resi- 
dence, at different times in the day, I found that 
the attacks of pain were regularly and distinctly 
paroxysmal ; that they were attended by the pecu- 
liar thirst so characteristic of Arsenic, and by the 
restlessness and anguish, and followed by the 
prostration, equally characteristic. Furthermore, 
concomitant symptoms in the shape of an Arsenic 
gastralgia and an Arsenic diarrhoea were also 
present. It then occurred to me that this was 
probably a case of masked intermittent. The situ- 
ation of the house, and the topography of the 
neighborhood favored the idea. On the strength 
of the symptoms recited, I gave Arsenicum 2co . 
Within five days the pains had ceased to appear, 
but in their stead came a regular paroxysm of 
chill, fever and sweat, indicating the existence of 
quotidian intermittent fever. These paroxysms 



ARSENICUM ALBUM. 



199 



recurred for four days, gradually diminishing in 
intensity. They then ceased, leaving the patient 
well. 

Instances almost without number might be 
adduced in corroboration of this statement, that 
cures are to be made in a multitude of instances 
which present local symptoms and lesions of tissue, 
to which the symptomatology of the drug presents 
no analogy ; provided always the general and con- 
stitutional symptoms correspond closely to those 
which characterize the drug. And it may be added 
that perhaps no other drug is so often useful and 
available in this way as Arsenic, for the reason 
that hardly any other drug produces general symp- 
toms so strongly marked, and so easily detected ; 
I may add, so frequently met with in patients. 
Whatever, then, may be the local nature of the 
disease before, whatever pathological name it may 
bear, if the general symptoms correspond to those 
of Arsenic in the way that I have pointed out, do 
not hesitate a moment to give that drug. (How 
otherwise could we cure lupus, cancer, ulcers ; for 
these do not occur in provings !) 

The eminent periodic character of the action of 
Arsenic upon the healthy subject, would mark it at 
once as a drug likely to be very useful in the cure 
of intermittent fever. But long before systematic 
provings on the healthy body had made known to 
us this peculiarity, popular experience had dis- 
covered the value of Arsenic in such cases. It 
was found to be the sole ingredient of a nostrum, 



200 



ARSENICUM ALBUM. 



very famous in the last century under the name of 
"the tasteless ague-clrop." 

During the wars consequent on the French 
Revolution, and the Napoleonic wars on the conti- 
nent of Europe, while England held control cf the 
ocean and effectually blockaded the European sen- 
ports, thereby preventing the importation of foreign 
products, and among them of Peruvian bark, the 
recognized specific for intermittent fever (for, what- 
ever opinion the English may now entertain of the 
barbarity of our withholding medicines from our 
enemies, they had then no doubt of the propriety 
of withholding them from theirs) ; — at this time 
attention was turned to the practicability of using 
Arsenic as a substitute for bark in treating intc-- 
mittent ; and large rewards were offered for an 
effectual method of so using it, or for any efficieii- 
substitute for bark. It is amazing that this idea 
of using one specific as a substitute for anothcr 
specific could ever be entertained ; since the virtues 
of a specific reside in its peculiar, individual prop- 
erties, which are never common to two different 
substances. Nevertheless, even at the present day 
and in our latest works on materia meclica, we find 
the subject of the substitution of Arsenic for Quinine 
gravely discussed, and statistics referred to to show, 
as the case may be, its inferiority or superiority to 
Quinine. As might be supposed, the testimony of 
different physicians diners widely on this point. 
Some affirm that almost all the cases treated by 
them during a certain period, were promptly cured 



ARSENICUM ALBUM. 



20I 



by Arsenic, while they proved rebellious to Quinine. 
Others succeeded with Arsenic in a smaller pro- 
portion of cases, and in a larger with Quinine; 
while others, again, found Arsenic of comparatively 
little use, Quinine curing nearly every case. Finally, 
others again failed with Arsenic and Quinine alike, 
but succeeded with other drugs less often used, as 
Ipecacuanha, or Eupatorium, or Nux vomica. 

Now, it is a wonderful thing that medical men 
should still argue, in the face of these statistics, 
upon a question of the relative value of certain 
drugs in the treatment of a disease, regarded not 
in the light of the individuals affected by it, Lut 
solely with reference to its great pathological feat- 
ures. It seems to me the only sound deductions 
from these testimonies are these : That there are 
diversities in the form in which intermittent fever 
appears in different persons and in different epi- 
demics ; that these forms require different remedies, 
and that thus there is a form which is capable of 
being cured by Arsenic, and by nothing else; a 
form capable of being cured by Quinine, and by 
nothing else; and so of other drugs. In this view, 
when a case of intermittent feven presents itself, 
the question can never be : Is Arsenic a better 
• remedy for this disease than Quinine is ? Does it 
offer greater chances of a cure ? There can be no 
better or worse. The question is between right 
and wrong ; suitable and not suitable. The ques- 
tion would be always : Which remedy corresponds to 
this particular case, and is, therefore, indicated in it? 



202 



ARSENICUM ALBUM. 



Attention should again be called to the fact 
which has been previously mentioned (see Bryonia), 
that in different epidemics the indications, though 
uniform, . are often quite different ; and that in the 
endemic fevers of certain malarious districts, the 
indications for remedies are often very uniform, and 
yet different for each locality. Thus it has been 
found, by experience, that the intermittents which 
are endemic near Rome (Italy), require Quinine or 
China ; those of the head of the Adriatic require 
Arsenic ; those of the Maremma, along the Tuscan 
gulf, require Bryonia ; those of Salonica, in Tur- 
key, yield to Ammonium muriaticum ; while those 
of the Dobrutscha require Rhus toxicodendron. 

The special indications for Arsenic in intermit- 
tent are thus admirably stated by Dr. Wurmb 
( " Homceopathische Clinische Studien," i., 179): 

"Arsenic is one of those few drugs whose 
action is distinguished not alone by its inten- 
sity, but equally by its extent ; it involves the 
entire organism. Every system, every organ of 
the body, every nervous filament, is so subjected 
to its powerful influence that we are not able 
to say which of its symptoms are primary, and 
which are secondary, and where the focus of its 
action chiefly lies. 

" We see the entire nerve-life attacked in all 
directions, from the slightest excitement to the 
most violent irritation ; from the mere sensation of 
weakness to actual paralysis ; and then we see, 
likewise, another series of disturbances arise from 



ARSENICUM ALBUM. 



203 



its action, which advance in regular gradation from 
the most inconsiderable acceleration of the circula- 
tion to the most violent febrile storm ; from the 
slightest irregularity in the vegetative sphere to a 
cachectic dyscrasia, yes, even to decomposition and 
destruction of the organic substance. 

"In addition, we remark the striking similarity 
between the symptoms of chronic, arsenical poison- 
ing and those of the intermittent cachexy ; as well 
as the fact that Arsenic has the property of causing 
the periodical recurrence of symptoms in so high 
a degree as to surpass in this respect all other 
drugs ; in a word, no other drug known to us has 
such a power of affecting so intimately and so 
variously those organs that are especially affected 
in intermittent fever ; and none corresponds so 
well as Arsenic does to all the requirements of a 
remedy for intermittent. * * * 

" Arsenic is indicated in cases which are dis- 
tinguished not only by weakness in the vital power 
and deterioration of the organic substance, but also 
and at the same time by symptoms of excitation 
of the circulation, or of the nervous system alone, 
or of both together. 

"Again, it seems to be the more especially 
indicated the more malignant the influence from 
which the disease has sprung. Marsh-miasm is the 
chief of these influences ; in this originate the 
most serious and most dangerous cases of fever; 
and in these, Arsenic is often the only remedy that 
will rescue the patient. 



204 



ARSENICUM ALBUM. 



"Again, the longer the disease has lasted, the 
more is Arsenic generally indicated ; because the 
more deeply have the organs and tissues been 
affected, the more nearly has the patient's condition 
approached that known as the intermittent cachexia, 
and which so nearly resembles the arsenical cachexia. 
Especially is this the case when the liver and the 
spleen have become swollen. 

"The intermittents which- find this homoeopathic 
remedy in Arsenic present in their paroxysms the 
following peculiarities : the paroxysms are general, 
violent, and of long duration ; the stages are either 
distinctly developed, and equally proportioned to 
each other, or else, as is most frequently the case, 
the one or the other stage is absent, or is very 
feebly present ; if the latter be the case, it is gen- 
erally the cold stage which fails, and the hot stage, 
is all the more violent. The more intense the heat, 
the longer it continues, the higher the degree of 
development of the accompanying excitement in 
the vascular system, and the more burning and 
insatiable the thirst, the better is Arsenic indicated. 
The sweating stage may be altogether wanting ; 
or the perspiration may be very copious ; it breaks 
out generally several hours after the end of the 
hot stage, and lasts a long time. 

" With the paroxysms are associated many 
distressing accessory symptoms, which are con- 
nected, some with the disturbances in the ner- 
vous system, some with those of the vascular 
system, e. g., spasms, pains, delirium, paralyses, 



ARSENICUM ALBUM. 



205 



and the anguish and restlessness that are so 
characteristic of Arsenic. 

' The apyrexia is not pure, but is disturbed by 
symptoms of the most various kinds ; restlessness, 
sleeplessness, spasms, digestive disorders, feeling of 
weakness and general prostration ; and it is espe- 
cially characteristic for Arsenic, that, after every 
paroxysm, there is a notable increase of pros- 
tration." 

Much of what has been said will serve to point 
out the indications for Arsenic in continued fever 
as well as in intermittent. A careful analysis of 
the symptoms of Arsenic shows them to be a 
mixture of prostration and of destruction in the 
vegetative system, with erethism and excitement in 
the animal system and in the circulation. In this 
respect it is related to Rhus toxicodendron, being 
more active and more penetrating in each respect 
than Rhus. As representing torpor and collapse 
without erethism, we have already (following 
Wurmb) mentioned Phosphoric acid as the less 
powerful and Carbo vegetabilis as the more power- 
ful drug, — correlatives respectively of Rhus toxico- 
dendron and Arsenic. 

Wurmb thus describes the typhoid fever in which 
Arsenic is indicated : 

" The patients are very restless and anxious, 
and generally so weak that they move only the 
hands, feet and head, and not the trunk ; and hence 
do not voluntarily change their posture in bed. 
The pulse is very frequent, small and irregular; 



206 



ARSENICUM ALBUM. 



the temperature greatly elevated, the cheeks burn- 
ing hot and red, the thirst insatiable. With these 
symptoms of excitement those of decomposition of 
the blood hold equal pace, as is shown by the 
exanthema and ecchymoses, the often profuse 
haemorrhages from various organs, the character 
of the blood thus excreted, and the destruction 
of the tissues in the parts on which the patient 
lies. 

" The sensorial functions are withdrawn from 
the influence of the will ; the delirium is always 
full of anguish and distress, and is sometimes 
violent, but more frequently is muttering. There 
are sudden startings and jerkings of muscles in 
the face and trunk. 

" The patients often perceive nothing, and com- 
plain of nothing ; the excretions pass involuntarily, 
but the urine is frequently retained, and the bladder 
is often so distended as to threaten a rupture, 
which indeed really takes place if the urine be not 
drawn off. The lips and tongue are dry, the latter 
often hard and either clean and dark red, or else 
thickly coated, the coat being a dark-brown fur, 
which also covers lips and teeth ; speech is often 
impossible. 

" The stool bears the marks of colliquation ; 
the stools are frequent, watery and bloody ; the 
flatulent distention of the abdomen is enormous. 
There is rattling in the lungs. Emaciation is very 
rapid and very great. In such cases perforation of 
the intestine is a common occurrence." 



ARSENICUM ALBUM. 



207 



The indications for Arsenic in neuralgia, in 
affections cf the eyes and teeth, must be drawn 
from the character of the pain and from the gen- 
eral symptoms. In cholera morbus, in diarrhoea, 
and in malignant dysentery, it may be indicated, 
as the symptoms, both general and local, already 
described, clearly show. 



HYDRARGYRUM. 



A METAL known to the ancients. 
It was used medicinally by the Arabs, from 
whom the Europeans derived a knowledge of it 
through the Moors of Spain. Its general introduc- 
tion into medical use is ascribed (perhaps wrongly) 
to Paracelsus (died 1 541 ). 

At ordinary temperatures, Hydrargyrum is 
liquid, hence its name liquid silver, or quick, that is, 
living silver. It freezes at 39.4 0 Fahr. and boils 
at 662 0 Fahr. It is very important to know that 
it gives off vapor at ordinary temperatures, and 
that from the inhalation of these vapors serious 
poisonings have resulted. 

No drug, not even Opium, is in so constant 
and universal use among medical practitioners of 
the old school as Mercury. No drug has wrought 
so much mischief upon the human race through its 
abuse. Like every other drug, it has its proper 
place in the treatment of disease. This place can- 
not be supplied by any other drug. When used 
in this proper place, and used in a proper manner, 
it is a most powerful instrument for good. These 
considerations require that the subject of the prop- 



HYDRARGYRUM. 



209 



erties and uses of Mercury should be carefully 
and fully treated. 

Mercury has been and is used in various forms : 

1. Metallic Mercury, Hydrargyrum. 
Mercurius vivus of Hahnemann, prepared for 

use by homceopathicians, by triturating Hydrargy- 
rum with Milk Sugar, according to the rules of the 
Homoeopathic Pharmacy, until the required attenu- 
ation is reached. 

2. Hydrargyrum cum creta. Mercury with 
chalk. Trituration 3 oz. H. to 5 oz. 

3. Pillulae Hydrargyria^. Blue pill. Blue mass. 
Mercury 1 oz., confection of roses oz., pow- 
dered liquorice root \ oz. 

Then there are combinations of metallic Mer- 
cury with fats, for external use. 

4. Unguentum Hydrargyri. Mercury 2 lbs., 
lard 23 oz., suet 1 oz. 

5. Black oxide, protoxide ; the precipitate in 
black wash. 

6. The Hydrargyri oxydum rubrum. 

Red deutoxide. Red precipitate, used chiefly in 
the red precipitate ointment. 

7. Black sulphuret, or Ethiop's mineral. 

8. Red sulphuret, bisulphuret ; cinnabar. 

9. Dichloride, Subchloride ; Hydrargyri Chlo- 
ridum mite ; mild chloride of Mercury ; Calomel- 
anos ; calomel ; prepared by treating a sulphate 
of the protoxide of Mercury with chloride of 
Sodium, — two atoms of Mercury and one of 
chlorine. 

II. — 15 



210 



HYDRARGYRUM. 



Its English name, calomel, which signifies 
"beautiful black," is said to have been given it by 
Sir Theodore Mayerne, in compliment to a negro 
who assisted him in preparing it. 

The officinal compound cathartic pill contains 
calomel, with compound extract of colocynth, ex- 
tract jalap and gamboge. 

10. Hydrargyri chloridum corrosivum ; "bichlo- 
ride of Mercury"; corrosive sublimate. Generally 
regarded as a bichloride, but really a chloride. An 
acrid poison of great activity, forming a scarlet 
precipitate with iodide of potassium, and insoluble 
compounds with albumen and fibrine. 

11. Hydrargyrum ammoniatum. Ammonio- 
chloride of Mercury. White precipitate, precipitated 
by ammonia from a solution of corrosive sublimate. 

12. Hydrargyrum iodidum. 

13. Hydrargyrum biniodidum. 

14. Hydrargyrum oxydulatum nigrum. Nitras 
ammoniacus cum cxydo hydrargyroso. Mercurius 
solubilis Hahnemanni. Ammonio- nitrate of Mercury. 

Soluble Mercury of Hahnemann. 

Three parts of pure quicksilver are treated with 
four parts of concentrated nitric acid until about 
two parts of the quicksilver are dissolved. To the 
hot solution are then added twelve parts of dis- 
tilled water ; it is filtered, and to it is added a 
mixture of one and a half parts of strong aqua 
ammonia, sp. gr. .95, and eight parts of distilled 
water. A black precipitate is formed, which is the 
soluble Mercury of Hahnemann. 



HYDRARGYRUM. 



211 



It is a tasteless, black powder, volatile in 
heat. 

This preparation was introduced by Hahnemann 
into medicine, long before he had made any of 
those discoveries and observations which afterward 
became known as homoeopathy. It was extensively 
used as a mercurial preparation, more certain and 
less severe in its action than calomel or corrosive 
sublimate, and is still highly esteemed and much 
used in Europe, especially in Paris, at the hospital 
St. Louis. 

Hahnemann's excellent proving of Mercury was 
made chiefly with this preparation. 

In treating of the action of Mercury on the 
organism, I propose to follow Hahnemann's proving 
of mercurius solubilis ; speaking afterward of dif- 
ferences in the action of other preparations. 



GENERAL ANALYSIS. 

The action of Mercury is most profound and 
extensive. It affects the entire organism. The 
sensorium, the nerves of reflex function, and those 
which preside over vegetative life, are all modified 
in action. The substance of every tissue is more 
or less altered. 

But, in considering the action of Mercury on 
the vital force, we distinguish at once that its 
action on the sensorium, on the nerves of animal 
life, is subordinate to that on the nerves of vege- 



212 



HYDRARGYRUM. 



tation. Here is a distinction at once between 
Mercury and the narcotics or cerebrants. 

The nutrition is depressed by Mercury in a 
wonderful degree. Yet this depression is conjoined 
with a high degree of erethism, so great as often 
to mask the depression. Here is an analogy with 
Arsenic, and a distinction from Lachesis and Carbo 
vegetabilis. 

On the organic substance, Mercury works emi- 
nent destruction in every tissue. The skin is the 
seat of destructive ulceration, so is the mucous 
membrane, so are the lymphatic glands, so are the 
bones, especially the alveoli. The periosteum is 
likewise destructively affected. Even newly organ- 
ized deposits, the result of disease, are unques- 
tionably absorbed and removed by Mercury. 

The secretions, especially from the glandular 
surface (salivary and pancreas) are increased and 
altered. These and those from the intestines 
betoken destructive changes in the blood compo- 
sition. The sweat is increased. The color of the 
blood becomes depraved, — witness the sallow com- 
plexion and the pale and flabby tongue. The 
albuminous constituent of the blood passes away 
through the kidney, — whether from change in the 
composition of the blood, or from change in the 
kidney, or from both, pathology has not yet taught 
us, — and we have albuminuria. 

The subjective symptoms corroborate tkis view. 
The exhaustion consequent on the action of Mer- 
cury can hardly be expressed. It is sickening and 
death-like. 



HYDRARGYRUM. 



213 



The all-pervading character of Mercury is a 
subject of ocular demonstration. Metallic Mercury 
has been found in every tissue of the body of 
those who have taken it as a medicine. Its per- 
sistence is likewise demonstrable. Once introduced 
into the system, it remains. Some remarkable 
instances of this are on record. 

In cats that had been rubbed with Mercurial 
ointment, CEsterlen found globules of Mercury in 
the pancreas, liver, spleen, lungs, heart, mesenteric 
glands, kidneys, etc., and also in the bile, milk, 
urine and saliva. Van Hasselt has proved that 
metallic Mercury itself, and not merely the oxide, 
is absorbed. 

It is notorious that nurses and internes in hos- 
pital wards become salivated from inhaling the 
mercurial atmosphere of these wards. (Colson, in 
"La Pitie," 1821-24; an d Goulard, Van Swieten, 
"Comments," 1726.) 

In 1 8 10, Briickmann published an account of a 
lady who, a year after being salivated, having 
become violently heated by dancing, had dark 
stains appear upon her breast, and metallic Mer- 
cury was found upon her linen. Here a year had 
elapsed since she had taken Mercury. 

Jourda gathered a quantity of metallic Mercury 
from the urine of a syphilitic patient who was 
taking Mercury. 

Elk and Buchner found it in the blood of a 
person who had been salivated. Colson found that 
a brass plate, which had lain for some time in the 
blood of a person treated by Mercury, became 



214 HYDRARGYRUM. 

covered with a coating of Mercury. Biett, by a 
prolonged use of the warm bath, got Mercury 
from the axillary glands of a mercurialized syph- 
ilitic patient. Gmelin detected Mercury in the 
saliva of a person who had been salivated by mer- 
curial inunction. So did CEsterlen and Andouard 
and Lehmann. 

In this connection Melseus reminds us it would 
be improper to overlook the fact, that when Mer- 
cury has been taken so as to produce its constitu- 
tional effects, and these have entirely disappeared, 
they may long afterward be re-excited by the 
action of medicines, which, becoming decomposed 
in the system, form soluble compounds with Mer- 
cury. One of these is the iodide of potassium. 
Therefore, iodide of potassium has been recom- 
mended as a cure for symptoms which depend on 
Mercury retained in the economy (Melseus), and it 
is held by many that iodide of potassium is useful 
only in those cases of constitutional syphilis in 
which the body has been impregnated with Mercury; 
the action of which it certainly has the power of 
re-awakening. 

These facts show the permanence of the action 
of Mercury ; how it makes itself at home in the 
organism and "will not out." 

A few more facts may be cited to show its 
diffusibility, and its penetrability into the tissue. 

A quantity of metallic Mercury escaped from 
the bags, in which it was being conveyed, into 
the hold of a vessel. Not only were all the 



HYDRARGYRUM. 



215 



vermin on board killed, but die crew were all 
salivated. 

In Idria, where the ores of Mercury are 
smelted, the whole population is affected. The 
mortality is one in forty. Premature births and 
abortions are very common. Even the cows are 
salivated and cachectic, and abort. 

The chronic diseases, and especially the mercu- 
rial trembling, produced on gilders, are well known. 

Even the secretion of milk in nursing women is 
altered ; and infants who take it become mercuri- 
alized. This fact has been made use of therapeu- 
tically ; and nurses have been mercurialized in 
order that their milk might be the vehicle for 
administering Mercury to infantile victims of con- 
genital syphilis ; and this has been successful, too. 
(Bouchut: "Maladies des Enfans.") 

I cannot forbear interrupting the methodical 
treatment of this subject to call attention to the 
facts that : 

1. Mercury is shown by the above evidence 
to permeate the tissues, reaching every part of the 
body. This leaves no room for doubting that it 
acts on the tissues by virtue of its presence in 
them. When we desire the action of Mercury, 
therefore, upon the tissues, the indication is to 
minutely subdivide it, so as to facilitate its intro- 
duction into the tissues. 

2. Mercury acts energetically on the system 
when presented to it in inconceivably small quan- 
tities, in a most attenuated form. 



HYDRARGYRUM. 



It is difficult to estimate the quantity of Mer- 
cury that can be contained in the exhalations from 
the bodies and from the saliva of persons laboring 
under mercurial salivation. How much more diffi- 
cult is it to express the infinitesimal smallness of 
the dose of Mercury which salivates an infant, 
given in the milk of a mercurialized nurse. Two 
grains of calomel judiciously used will salivate an 
adult. Let the average weight of the nurse be 
125 pounds, equal to 720,000 grains. Considering 
the nurse as the non-medicinal vehicle in which 
those two grains of calomel are distributed, you 
have here about what homceopathicians would call 
the third centesimal dilution of calomel. But 
remember that the tissues of the nurse are con- 
stantly undergoing change, that she is constantly 
secreting fluids, in which Mercury can be detected 
by chemical re-agents. It appears at once that the 
dose is equivalent to a much higher dilution. 
Then consider that the effect is violent salivation, 
much more powerful than is needed for a cure. 

When all these things are duly weighed, is it 
not amazing that physicians who testify to and 
accept all these marvelous facts, will accord neither 
merit nor credence to homceopathicians, who divide 
the drug very minutely, in order that it may easily 
penetrate the tissues ; and who give exceedingly 
small doses, even smaller than those given by Bou- 
chut, through the intervention of the nurse. 

Peculiarities. It may be mentioned as a 
peculiarity of Mercury, that the symptoms are 



HYDRARGYRUM. 



aggravated just after getting warm in bed, and that 
they are attended by a disposition to sweat. 

Periodicity is not strongly marked in the action 
of Mercury, though salivation has been known to 
recur regularly at certain seasons for years. (Stille.) 

The first appreciable effect of a moderate dose 
of Mercury is an increased activity of the secre- 
tions, particularly of the intestinal canal ; the 
discharge becoming liquid and bilious. The mucous 
membrane of the respiratory apparatus, and some- 
times also of the urino-genital, displays a similarly 
augmented secretion. Then the appetite fails, 
digestion is impaired, the secretions become still 
thinner and more copious, the firmness of the 
tissues diminishes, recently healed wounds open 
afresh ; the muscles waste, the skin becomes 
earthy-pale, the eyelids and ankles become cedema- 
tous, and even general dropsy may ensue. .. These 
symptoms seem to depend on a radical change 
which the blood has undergone by losing a large 
proportion of its normal, solid constituents, and 
perhaps a portion of that vitality on which its 
coagulability in part depends. The unwonted 
fluidity of the blood predisposes to haemorrhages, 
which may become dangerous. 

Salivation takes place. It is often preceded by 
an erethism of the system, in which, beside the 
increased secretions already noticed, the patient 
loses appetite, but has a quick and frequent pulse, 
and manifests great nervous excitability. If the 
salivation is profuse, this state is strongly marked. 



218 



HYDRARGYRUM. 



As the system is becoming mercurialized, there 
is a coppery, metallic taste in the mouth, and the 
teeth are sore when struck together. The breath 
acquires a characteristic fetor. The gums become 
puffed, with a red line along the attachment to the 
lower teeth. This redness gradually extends to the 
whole buccal, mucous surface. The tongue is 
coated with white slime, has a sodden, dough-like 
look, and bears on its margin the imprint of the 
teeth. 

The salivary glands become swollen and tender, 
the saliva is increased in quantity, it is ropy, 
alkaline, and has a penetrating taste and smell. 
The daily discharge sometimes amounts to several 
pints. In bad cases it is very distressing. The 
mouth and tongue swell, the patient cannot speak 
or eat ; extensive ulcers, sometimes coated with 
false membrane, appear on the gums, cheeks and 
fauces ; and in healing, these sometimes cause 
adhesions of adjacent parts ; oedema glottidis may 
occur, the breath is horribly fetid, the teeth loosen 
and fall out ; and caries attacks the residue and 
the maxillae. 

The digestive apparatus is affected, appetite 
impaired, tongue coated ; there is nausea, with 
oppression, and sometimes pain and tenderness at 
the epigastrium ; the bowels are loose, and the 
stools often contain blood. GEsterlen found metallic 
Mercury in the intestine of a person who had used 
the medicine only by inunction. 

It used to be thought to increase the discharge 



HYDRARGYRUM. 



2 19 



of bile, though how it does so is disputed. But 
it does not. 

It certainly produces enlargement of the liver. 
Dr. Cheyne says it actually produces jaundice. 
(The homceopathicians know from daily experience 
that it cures some forms of jaundice.) It pro- 
duces green stools. (Green stools are not always 
bilious.) 

It produces great depression, great sensibility 
to cold, pain in the limbs, irritability. 

It causes menorrhagia. 

It causes albuminuria (and cures it). 

In persons long exposed to its vapor it causes a 
singular quasi-paralysis, the "mercurial trembling." 
This is gradual in its approach, beginning with 
formication of the hands and sometimes of the 
feet, and with more or less pain of the thumbs, 
elbows, knees and feet, which also renders the 
movement of these parts imperfect. After a time 
the hands begin to tremble, and then the arms and 
lower limbs, the muscles of the lower jaw and 
tongue, and indeed all the muscles of animal life. 
The muscular contractions take place rapidly, but 
by starts, so that the patient feeds himself with 
difficulty. Walking is difficult from the same 
cause. So are articulation and mastication. It 
resembles chorea, being worse from mental emotion 
and relieved by alcohol. Sometimes single groups 
of muscles are absolutely paralyzed. 

Mercury produces also an irritative fever. The 
patient is weary and chilly. The pulse is frequent 



220 



HYDRARGYRUM. 



(not full nor hard), tongue coated, great tendency 
to perspire, skin very sensitive to cold, often 
relieved by salivation. 

Mercury produces a skin affection, which may 
be a rash, closely resembling measles ; or a miliary 
eruption, or an erysipelatous inflammation, or a 
gangrene. 

Ulcers appear on the gums, on the inside of 
the cheeks, and on the tongue, attended with 
salivation. These ulcers usually advance from 
within outward, raising and then casting off the 
epithelium, and exposing a red, irritable surface, 
which secretes an acrid fluid. They are irregular 
in shape, without defined edges ; they bleed readily, 
have a dirty, whitish surface, are surrounded with 
a dark halo, and are apt to run together. 

Let me call attention to the difference between 
these and syphilitic ulcers of this membrane. The 
latter are "circular, attack the posterior parts of 
the mouth, have well-defined edges ; the surround- 
ing membrane has a coppery hue, and they do not 
extend from their primary seat." I may remark 
that these ulcers find their remedy more often in 
Nitric acid than in Mercury. 

Haemorrhage may occur from these mercurial 
ulcers, or they may prove fatal by gangrene. 

The destructive action of mercury on the glands 
'lymphatic) is unquestionable. Ulceration of both 
the inguinal and axillary glands occurs. 

The bones are the seat of destructive inflam- 
mation. Periosteal nodes appear, which ulcerate, 



HYDRARGYRUM. 



22 1 



and then ulceration progresses from without inward 
into the bone. Canstatt says "it is most frequent 
in the spongy bones at the base of the cranium, 
and in the ends of the lono- bones." 

To these details of the general action of Mer- 
cury on the human organism I shall append the 
finer and more exact data which resulted from 
Hahnemann's proving on the healthy subject: 

1. As regards the action on the skin, the 
eruptions itch ; the discharge from them is acrid, 
excoriating adjacent surfaces. Indeed, this is a 
general characteristic of the secretions under Mer- 
cury, from the discharge in ophthalmia to the 
intestinal evacuations. They cause smarting and 
excoriation. Intertrigo is common. 

Further, there is a general itching about the 
joints and over the body in the evening and at 
night. 

2. Limbs. Tearing and drawing pains, worse 
at night ; the limbs twitch. There are lassitude and 
soreness ; all the bones ache. 

Jaundice ; the perspiration stains the linen 
yellow. 

Great disposition to perspire on slight exercise. 

As a general thing the symptoms are aggra- 
vated in the evening, and during repose, when 
lying or sitting. Great restlessness in the limbs 
in the evening ; cannot remain anywhere quiet nor 
in any position ; must constantly change posture. 

Great weakness and prostration, yet orgasm of 
the blood ; erethism. 



222 



HYDRARGYRUM. 



Sleepiness by day, not relieved by long sleep. 
Difficult falling asleep in the evening, because of 
restlessness, anxiety, etc. Sleep at night disturbed 
by frequent wakings, and dreams which terrify. 

The fever, which is irritative, is attended with 
decided thirst. Very marked is the disposition to 
sweat, which occurs during sleep. The heat is 
attended by great anxiety, and by the peculiar 
gastric symptoms of Mercurius. 

The disposition is restless, anxious, irritable, and 
yet despondent. 

Vertigo with nausea, distracted thoughts, moment- 
ary loss of vision. 

Headache. Tearing, burning in the temples; 
semi-lateral tearing in the head at night, as if the 
head would burst, along with soreness and a tired 
aching in the nape of the neck. Sensation as if 
the head were bound around with a hoop. 

Eyes. The margins of the lids are ulcerated 
and scabby. Ophthalmia and intolerance of fire- 
light. Great lachrymation. Pain as from a cutting 
body under the eyelids. Biting and burning in 
the eyes, especially in the open air. Black spots 
before the eyes. Photophobia. 

Ears. Earache, with tearing or stitching pain. 
Ulceration of the concha. Discharge of blood and 
offensive pus from the ears. Fungous growths in 
the meatus. Swelling of the parotids. Deafness, 
relieved by blowing the nose. Noises in the ears. 

Nose. Red, shining swelling of the nose. 
Epistaxis. Earthy, yellow complexion. Dirty yel- 



HYDRARGYRUM. 22 T, 

low scabs in the face, which bleed when scratched. 
Swelling of the submaxillary and cervical glands. 

The Gums swell and burn, and are sore, worse 
at night, worse by touch and by eating. Ulcera- 
tion. Teeth are loose. 

Toothache, tearing at night, excited by cold air, 
by eating, and by both cold and warm drinks. 
Worst in the evening and at night; intolerable 
when warm in the bed. 

Offensive smell from the mouth. Burning ulcers 
or aphthae. Swelling of the soft palate and fauces. 
Burning and ulceration of the fauces. Constant 
disposition to swallow. When swallowing, sticking 
pain in the throat and in the tonsils. Copious, 
offensive saliva. Swelling of the tongue. Indura- 
tion and ulceration of the tongue. Cannot talk. 
Voice hoarse and rough. 

Canine hunger. Aversion to food. 
Insatiable, burning thirst. 
Flat, putrid or metallic taste. 
Nausea, with sweetish taste. 
Weak digestion, with constant hunger, oppres- 
sion of the stomach, and feeling as if the stomach 
were dragged down after each meal. 

Inflammation and hardening of the liver, with 
stitching pains. 

Abdomen distended, with soreness ; cutting and 
pinching pains. 

Stool. Frequent desire for stool, ineffectual, 
especially at night. Dysenteric diarrhoea, with 
tenesmus. Tenesmus continues after stool. Stools 



224 HYDRARGYRUM. 

acrid, of bloody mucus. Sour-smelling, green, acrid 
stools. 

Prolapsus ani, when straining at stool and afte_ 
stool. 

Frequent, rapid urination, with scanty discharge, 
often followed by discharge of mucus. Urine dark- 
red, offensive, or it may be very abundant and 
light. 

Menses too copious, with anxiety and abdominal 
cramps. Leucorrhcea purulent and acrid. 

Violent fluent coryza, with an acrid watery 
discharge, making the nose and lip red, and very 
sore. 

Dyspnoea on rapid motion. 

Dry fatiguing cough — as if the head and chest 
would burst — from tickling in the larynx. Hemop- 
tysis. 

Burning in the chest ; palpitation. 
Secretion of the mammary gland repulsive to 
the infant. 

Upper Extremities. At night, tearing in the 
shoulder and arms. Hot, red swellings in the fore- 
arm. The fingers crack. Paronychia. 

Lower Extremities. Tearing in the legs at 
night. Dropsical swelling of the feet and legs. 
Painful swellings on the bones of the feet and 
legs. 

The warmth of the bed increases all the symp- 
toms until they become intolerable. 

The practical applications of Mercury are very 
diverse. 



HYDRARGYRUM. 



225 



PRACTICAL APPLICATION. 

The discussion of the practical application of 
any remedy in the treatment of diseased persons 
should always be opened by the reminder that 
each diseased state is to be regarded as a new 
case, distinct from all others, and different from every 
other ; and that a remedy must be selected for it in 
accordance with the similarity which the symptoms 
produced by the remedy in the healthy subject 
bear to the symptoms of the sick person for whom 
it is selected. This cannot be too often repeated, 
nor too strongly insisted on. 

This being premised, I may call attention to a 
few cases in which Mercurius is more especially 
likely to be required and useful. 

And first, of general diseases. 

That in which Mercury was first employed, and 
in the treatment of which it has acquired the 
dignity of a specific, is syphilis. 

Touching this disease I desire to say, that in 
so far as my experience in the treatment of it is 
concerned, I have not found it less amenable to 
treatment than other constitutional maladies. The 
patient, otherwise in vigorous health, who presents 
himself for treatment, without having previously 
saturated his system with drugs, and without hav- 
ing undertaken to eradicate the morbific poison by 
caustic applications to its primary local manifesta- 
tion, the chancre — such a patient, if Mercury be 
II.— 16 



226 



HYDRARGYRUM. 



indicated by his symptoms, will be cured as readily 
and by as small doses as though his disease were 
something of a totally different character. (A 
prejudice to the contrary exists.) And my profes- 
sional experience satisfies me, that in these, as in 
other cases, the high potencies, and infrequent 
doses, produce a more speedy and a more effectual 
cure than low potencies and frequent doses do. 
But inasmuch as I do not regard the chancre as 
the "fons et origo mali," but rather as the blossom 
and product of a constitutional infection which 
already pervades the system, I am not in so great 
haste as some are to destroy the chancre, well 
satisfied if, under internal treatment, I perceive it 
gradually heal by healthy granulations, no other 
symptoms meanwhile appearing. Above all, I dread 
the local treatment by caustic, the much-vaunted 
method of Ricord. For observation has satisfied 
me that even a majority of his patients, discharged 
as cured through the local cauterization, present, 
after the lapse of from one to eight weeks, all the 
signs of secondary syphilis, and become candidates 
for, and victims of, the "constitutional treatment." 

It is not every case, however, of so-called 
chancre, for which Mercury is indicated. 

That which is now denominated chancroid, and 
which, being a shallow and flat-bottomed ulcera- 
tion, shows a disposition to spread irregularly and 
indefinitely, having never well-defined outlines nor 
a lardaceous bottom ; but exuding a thin, serous 
discharge, and which is probably not at all 



HYDRARGYRUM. 



227 



syphilitic in its origin, does not call for Mercury, 
and is not benefited by it ; indeed is rather aggra- 
vated. I have found the totality of the symptoms 
to indicate Nux vomica more frequently than any 
other drug, and under this a speedy cure to follow. 

The form of chancre in which Mercurius is 
indicated is the regular indurated Hunterian chan- 
cre, with the lardaceous base. 

In continued or remittent fevers, particularly 
those which are complicated with enlargement or 
sub-acute inflammation of the liver, Mercurius may 
be indicated by the symptoms. 

The peculiar headache of Mercurius — dullness 
in the forehead, stitches through the temples, a 
band around the head, and aching and weariness 
in the posterior cervical muscles, from the occipital 
ridge downward — is often found conjoined with 
gastric symptoms and a state of the tongue which 
clearly call for Mercury. 

A catarrhal or superficial otitis often exists, 
which is promptly relieved by Chamomilla or Pul- 
satilla, according as the characteristic indications 
for one or the other may be present. But there is 
another form, in which the inflammation is deeper 
seated, affecting the sub-mucous and sub-cutaneous 
cellular tissue, extending to the parotid gland, which 
becomes swollen and tender, and accompanied by 
throbbing pain, worse at night on getting warm in 
bed ; accompanied, too, by the tongue and gastric 
symptoms peculiar to Mercury ; in which Mercury 
is the proper remedy. 



22S 



HYDRARGYRUM. 



The throat affection that calls for Mercury is 
a parenchymatous tonsillitis, in which the pain is 
throbbing, the tonsil and fauces yellowish red, 
often covered with a thin, false membrane ; the 
breath fetid, the tongue pale, flabby, and indented 
by the teeth ; the pain on deglutition much greater 
than on empty swallowing. Salivation increased ; 
the throat sore externally when pressed. The differ- 
ence from the sore throat of Belladonna is evident. 
From that of Lachesis it will be differentiated in 
the lecture on Lachesis. It closely resembles that 
of Hepar sulphuris, which, however, has the sharp, 
sticking pain in the tonsil, as from a splinter. 

The stomatitis has been described. 

I may mention that qualmishness and a peculiar 
sense of weakness and tenderness at the pit ol 
the stomach, are very characteristic symptoms of 
Mercury. 

To be distinguished, however, from Calcarea 
carbonica, which has soreness and intolerance of 
pressure from the hand or by clothing ; and from 
Sepia and Murex purpurea, which have a " sink- 
ing," an " all-gone feeling," and a faintness and 
die-away sensation at the pit of the stomach. 

The stool of Mercury is a symptom of great 
importance. 

In large doses, Calomel produces copious semi- 
fluid, pasty evacuations of dark green or greenish 
brown faeces, with great weakness and prostration at 
the epigastrium, griping and soreness in the abdo- 
men, moderate tenesmus and burning in the rectum, 



HYDRARGYRUM. 



229 



with exhaustion after the evacuation. If the 
administration be continued, the discharges become 
frequent but small in quantity ; consist of mucus 
and blood mixed together, and often containing 
shreddy substance, like strips of mucous membrane; 
and are attended by tenesmus, which is not relieved 
by the evacuation of stool, but continues almost 
without interruption ; also with burning and sore- 
ness in the rectum and anus, as if the secretions 
were acrid. 

This describes a form of dysentery of which 
every year furnishes examples in practice. The 
chief point is to distinguish such cases from those 
which correspond better to Nux vomica or Podo- 
phyllum or Sulphur than to Mercurius. 

Under Mercurius the desire for stool is not 
relieved by the evacuation ; the patient would 
gladly sit and strain for an indefinite period. 
Under Nux vomica the tenesmus is relieved by 
stool ; and the patient enjoys a respite from suf- 
fering. 

Under Sulphur, likewise, the tenesmus is 
relieved by stool, and the Sulphur stools have the 
peculiarity that the blood is not uniformly mixed 
through the mucus, but occurs in thready streaks. 

It is needless, I hope, to remark that to those 
who are capable of looking at the entire condition 
of the patient, and of keeping their attention from 
being engrossed by the one group of symptoms 
made prominent by the patient's complaints, the 
general symptoms furnish an unfailing guide. For 



230 



HYDRARGYRUM. 



excellent distinctions between remedies for dysen- 
tery, I refer to Dr. Wells's articles in the "American 
Homoeopathic Review," iii. 

Homoeopathic preparations are : Mercurius solu- 
bilis ; Mercurius vivus ; Mercurius corrosivus 
sublimatus ; Mercurius protiodide and biniodide ; 
Cinnibaris. 

Proto iodatus. Throat symptoms. 

Tongue thickly coated, yellowish white at the 
back part, the front and edges being clean and red. 

Empty deglutition ; is painful. Desire to swal- 
low ; sense as of a lump in the throat. 

Posterior wall of the pharynx red and irritated, 
and dotted with patches of mucus and spots which 
look ulcerated. 

Patches on the tonsils and soft palate, easily 
detached. Worse on the right side. Great thirst. 



CUCUMIS COLOCYNTHIS. 



SQUIRTING CUCUMBER \ BITTER APPLE. 

WE use in medicine the pulp of the fruit, an 
exceedingly bitter and nauseous production. 
It was known to the early Greeks, and a great 
regard for its medicinal virtues is expressed by all 
the ancient writers. Among moderns it has fallen 
into disuse and some discredit, except as an ingre- 
dient of the officinal and other compound cathartic 
pills. 

It was classed as a drastic or as a hydragogue 
cathartic along with scammony and gamboge. 
And in modern times, under the sway of the 
physiological school, which denied to drugs the 
possession of any individual specific properties 
peculiar to each, according them only certain gen- 
eral properties which were common to them and 
other members of a group, it was thought that 
for Colocynth might be advantageously substituted 
some less powerful, perhaps, and less distressing, 
purgative. But we shall see that Colocynth has 
certain properties which no other drug possesses. 

I may remark, in passing, that it seems remark- 
able that physicians who dreaded the too powerful 



232 CUCUMIS COLOCYNTIIIS. 

action of Colocynth, should yet so often, — in seek- 
ing to blend with it a drug or a complex of drugs 
which should moderate and correct its vigorous 
action, — have selected for this purpose other power- 
ful drastic cathartics, such as scammony, gamboge, 
veratrum, black hellebore, etc. Nay, Dodonaeus 
even says that violent purges are the best cor- 
rigentia of Colocynth. It can hardly be but that, 
under the law " Similia similibus curantur" these 
violent drugs, to a great extent, neutralize and 
antidote each other. Of the fact of this neutra- 
lizing effect there can be no question. It is univer- 
sally admitted. Why may it not be accounted for 
by the same law which accounts for the subsidence 
of morbid symptoms through the action of the 
similar remedy ? 

But what a discovery was that of Hahnemann, 
so laughably simple, yet so unsuspected, that the 
too powerful action of a drug may be moderated 
by just diminishing the dose, and by going on to 
diminish it until the dose acts as gently as you 
wish. 

Another Columbus with another egg ! 

The action of Colocynth in large doses is 
shown forth by the following cases : 

"A woman, aged forty years, had a chronic 
rheumatic pain in the left thigh and left shoulder. 
A kind friend advised her to infuse half a pound 
of Colocynth in a half pint of red wine, and to 
drink the fluid before going to bed. By good fort- 
une she took only one-half part of the infusion. 



CUCUMIS COLOCYNTHIS. 



2 33 



Scarcely had she swallowed this, when she was 
seized with fearful pains in the region of the 
stomach, great anxiety, vertigo, faintness and 
cramps. She vomited several times without relief ; 
then evacuated copious stools, at first watery and 
feculent, then consisting of pure blood, with dis- 
tressing tenesmus ; along with these came large 
pieces of the 'inner membrane of the intestine. 
The pain then concentrated in the stomach and in 
the lower part of the rectum; the abdomen became 
collapsed ; at last the tenesmus ceased, and the 
patient gradually fell asleep. Great exhaustion fol- 
lowed, but she finally recovered." 

In another case of the kind, which proved fatal, 
the autopsy revealed that the intestines were red, 
with black spots, glued together by false membrane. 
A white fluid had exuded into the cavity of the 
abdomen, and in it white flocculi were floating. 
On the coat of the stomach here - and there an 
ulcerated spot could be seen. There was no trace 
of inflammation in liver, kidney or bladder. 

Hahnemann and six of his pupils proved Colo- 
cynlh, but the result was quite meagre. It was 
reserved for the Austrian Proving Society to show 
us a full picture of the pathogenesis of this drug. 

These provings, viewed collectively, show us, 
what indeed we knew before, that the effect of 
Colocynth upon the alimentary canal is immediate 
and profound, that it produces vomiting and purg- 
ing of watery matters, and then of mucus and 
blood ; great flatulent distention of the abdomen ; 



234 



CUCUMIS COLOCY.NTHIS. 



and cruel, griping, flatulent colic. They give finer 
shades of delineation, however, than cases of poi- 
soning could. 

Furthermore, they reveal to us an action of 
Colocynth that was heretofore masked under its 
violent action on the alimentary canal. I mean its 
power to produce neuralgia, affecting: i, the trifacial 
nerve ; 2, the solar plexus ; 3, the lumbar and 
femoral nerves and their branches. Yet this knowl- 
edge has enabled us to effect some most brilliant 
cures, and to grope our way toward others, which 
could never be clearly indicated by any proving. 
Furthermore, a power to affect the ovaries is 
shadowed in the proving of Colocynth. 



SPECIAL ANALYSIS. 

Upon the mind Colocynth exerts no deep action. 
It produces impatience, vexation, excitement, fol- 
lowed of course by prostration and dejection. 

Sensorium. Dullness of the head, vertigo, con- 
fusion. 

Violent headache, as if brought on by exposure 
to a current of air. Aching pain along the sagit- 
tal suture, increased by exercise and by stooping. 

Pressing and drawing pain in the left side of 
the forehead. Drawing in the forehead as if it 
would be pressed out. Digging in the left temple. 
Pulsation in the left temple, which afterward 



CUCUMIS COLOCYNTHIS. 



2 35 



changes to lancinations, the same being felt simul- 
taneously in the left shoulder. 

Tearing and tension in the left side of the face, 
extending to the ear and head. Cramp-like sensa- 
tion in the left malar bone, extending into the left 
eye. Feeling of pressure in the orbits near the 
root of the nose, with confusion in the head and 
chilliness. 

Scraping and burning in the mouth and throat. 
Eructations. Nausea. Vomiting of food and vom- 
iting of greenish fluid. Vomiting with diarrhoea. 

Pain in the stomach after eating. Fullness in 
the epigastrium. Squeezing and wringing pain in 
the stomach. 

Colic and diarrhoea after taking the least nour- 
ishment. 

Flying pains in the hepatic region. 

Constricting pain in the centre of the abdomen, 
recurring at short intervals, and passing into a 
sharp griping. 

Griping in the abdomen, especially about the 
umbilicus, like a cutting or squeezing ; relieved by 
bending forward or on evacuating the bowels. 

Pain in the whole abdomen, as if the bowels 
were squeezed between stones. 

Rumbling and commotion in the hypogastrium. 

The colic comes on every fifteen or twenty 
minutes, and is relieved by pressure and by bend- 
ing forward. 

Diarrhoea, with nausea. Stool semi-liquid, 
brownish yellow, retained with difficulty ; preceded 



236 CUCUMIS COLOCYNTHIS. 

by colic ; some tenesmus. Liquid frothy stool ; 
saffron yellow, and of a musty odor; watery- 
mucous and bloody stools. Sensation of weakness 
in the rectum. 

Abundant urine. Frequent desire to pass water, 
with burning in the bladder and stitches in the 
bladder; alternating with stitches in the rectum. 

Menses early and more abundant. 

Under Dr. Frohlich, Colocynth was proved by 
two young women, who both experienced, beside 
the symptoms of the abdomen and bowels, deep 
stitches in the ovaries on both sides, but worse on 
the left. 

The respiratory organs are not markedly 
affected. 

Drawing, lancinating pain in the left shoulder, 
extending thither from the left side of the face 
over the neck. Drawing pain and stiffness in the 
muscles of the left side of the neck. Generally 
this pain is relieved by motion. 

In the upper part of the nape of the neck, 
close to the occiput, a sensation as if a heavy 
weight were there. Rawness in the right scapula, 
a feeling as if the nerves and blood-vessels were 
stretched. Severe contusive pain from the right 
side of the neck down to the scapula. 

(It is to be remarked that with all these symp- 
toms there is no fever, no sensitiveness, no heat ; 
motion generally relieves.) 

Drawing and paralytic pain in the arms. 

The lower limbs are weak and heavy. 



CUCUMIS COLOCYNTHIS. 



237 



Tension in the right groin. Pressure at the 
left sacro-iliac articulation, with tingling at the sole 
of the foot. 

Drawing in the right thigh down to the knee. 
Pain darting from the tuber ischii to the knee. 
Drawing, darting and obscure pulsation in the left 
hip. Tingling in the left foot, with simultaneous 
pressure about the sacro-iliac articulation. Pulsation 
in the left gluteal region. Drawing in the right 
thigh down to the knee. 

Only during motion pain in the right thigh, as 
if the psoas muscle were too short ; better on 
ceasing to walk ; recurring on moving again. 

Cramp-like drawing in the internal femoral 
region. Stiffness of the knee, as if bound around 
with a cord. 

Tearing, drawing and pressure throughout the 
limb. 

Dr. Watzke of Vienna says : 

" The hemicraniae and prosopalgias which Col- 
ocynth will cure, are, in all cases, purely functional 
derangements of the filaments of the trifacial nerve. 

" In the prosopalgias of Colocynth there are no 
twitchings of the muscles, nor any palsied feelings 
in the affected side ; the pain follows the course 
of the nerve, is periodical, and accompanied by 
toothache." Colocynth is related to Belladonna, 
Capsicum and Verbascum. 

Colocynth is adapted to what Romberg describes 
as neuralgia hypogastrica, and which is often de- 
scribed and regarded in women as menstrual colic; 



23S CUCUMIS COLOCYNTHIS. 

and in men as hemorrhoidal colic ; attended by 
pains and aching in the thighs. 

" The intestinal affection indicating Colocynth is 
hardly inflammatory (and yet the autopsy shows 

it).- ' 

"The ischialgias are not due to strumous dia- 
thesis or to organic changes." 

And yet unless many skillful physicians have 
been greatly deceived, Colocynth has arrested and 
cured, in its early stages, morbus coxarius. 

It is not easy nor safe to undertake to distin- 
guish, in early stages, functional and organic affec- 
tions, and to set apart remedies for the one and 
for the other on pathological grounds. Experience 
gives the lie to our hypothesis. 

The presumptive action of Colocynth on the ova- 
ries deserves attention and experimental research. 



PODOPHYLLUM PELTATUM. 

THIS remedy has been flippantly called the 
" Vegetable Mercury." It resembles it no 
more than the "greenback" or paper dollar is like 
the precious metal which, by a financial fiction, it 
purports to represent. 

Podophyllum is a remedy of great value, and 
possessing a distinct individuality. It can neither 
be used as a succedaneum for, nor be replaced by, 
any other remedy. 

It was proved under the auspices of Dr. Wil- 
liamson of Philadelphia. A very extended essay 
upon it is contained in Hale's " New Materia 
Medica." 

I propose to notice, in a cursory way, some of 
its best established relations to the organism. 

And first, upon the digestive apparatus. 

The secretion of saliva is increased, the breath 
is offensive, tongue coated white, with a foul taste ; 
worse in the morning. 

Sore throat, beginning on the right side and 
going to the left. Dryness of the throat. Sore- 
ness extending to the ears. This is the reverse of 
Lachesis and the same as Lycopodium. 



240 



PODOPHYLLUM PELTATUM. 



Regurgitation of food ; increased appetite ; 
satiety from a small quantity of food, followed by 
nausea and vomiting ; thirst ; putrid taste. 

This satiety resembles Lycopodium and Nux 
vomica, but Lycopodium has also great flatulence; 
flatus being incarcerated under the false ribs. 

Acidity of the stomach, nausea and vomiting, 
heart-burn, heat and throbbing in the stomach, 
followed by diarrhoea. The vomiting is forcible, 
and the matter vomited is dark green. 

Much pain in the abdomen, as in the transverse 
colon, occurring cr worse about three a. m., and 
followed by diarrhoea. The colic is relieved by 
warmth and by bending forward while lying on the 
side. In this it resembles Colocynth colic. 

It is at first accompanied by general coldness, 
which soon gives place to heat and perspiration. 

Feeling of fullness ; weight and dragging in 
the hypochondria, especially in the right, with 
stitches, twisting pain, and heat. 

The stool is increased in frequency and altered 
in character. Diarrhoea occurs; frequent pappy 
yellow stools. Diarrhoea immediately after eating 
or drinking. Similar to Colocynth and China. 
Watery yellow stools without pain from three a. m. 
till nine a. m., followed by a natural stool toward 
evening. These forms of diarrhoea stool are fol- 
lowed by a sensation of great weakness in the 
abdomen, and especially in the rectum. This sen- 
sation of weakness in the rectum is characteristic 
of Podophyllum. 



PODOPHYLLUM PELTATUM. 24 1 

Besides this modification of stool, Podophyllum 
produces chalky evacuations, which are very offen- 
sive. 

Likewise, stools yellow, green or brownish and 
watery ; mucus streaked with blood ; and these 
attended by heat in the rectum, by flashes of heat 
running up the back, by painful tenesmus, and by 
a descent cf the rectum. Hence a valuable remedy 
in dysentery, especially when the patient complains 
of a sensation of weakness in the rectum. 

This prolapsus is to be distinguished from that 
of Ignatia, Carbo vegetabilis and Hamamelis, in 
that it occurs before the evacuation of feces and 
not after it. The anus is extremely sore. 

From these symptoms we might gather that 
Podophyllum would be a valuable remedy in pro- 
lapsus am following dysentery, in haemorrhoids, in 
dysentery, and in certain watery diarrhoeas, — an 
inference abundantly confirmed by experience. The 
time of occurrence and the concomitant symptoms 
furnish the distinctive indications. The diarrhoea 
generally occurs or is worse in the morning, and 
the stool is followed by a sensation of extreme 
weakness in the abdomen, or only in the rectum. 

From the green, watery diarrhoea and the evi- 
dent hepatic condition associated with it, one might 
think of Podophyllum in cases of diarrhoea during 
dentition ; and Drs. Williamson and Bell have used 
it successfully in dentition-diarrhoea where there was 
present also cerebral irritation, as shown by the 
following symptoms : 
II.— 17 ' 



242 



PODOPHYLLUM PELTATUM. 



Grinding the teeth at night, "rolling the head." 

It is to be noted also that in the symptoma- 
tology, the diarrhoea (yellow, watery) alternates 
with a morning headache — a heavy, dull headache 
in the forehead, with soreness of the forehead and 
eyes. Such an alternation is observed in many 
hepatic affections. It reminds one of Aloes. 

The urine is increased. 

Menstruation is retarded. There is much bearing 
down in the hypogastric and sacral regions, increased 
by motion and relieved by lying down. Like Sepia. 

Much pain in the region of the right ovary. 

Leucorrhcea thick and transparent, with bearing 
down in the genital organs, and constipation. 

Dr. Williamson and others have found Podo- 
phyllum a valuable remedy in prolapsus uteri, 
following parturition, especially when there was 
also a numb, aching pain in the region of the 
ovaries, particularly the left. 

I shall speak further only of the febrile symp- 
toms of Podophyllum. Dr. Williamson gives the 
following - indications: Chilliness in the evening or 
morning early, preceded by backache, accompanied 
by pressing in the hypochondria and aching in the 
joints of the extremities. Heat comes on before 
the chilliness disappears. Heat with delirium, 
loquacity, violent headache, and great thirst with 
loss of appetite. 

Sweat, during which the patient sleeps. 

Podophyllum has been used successfully where in- 
dicated, in intermittent, remittent and typhoid fevers. 



LACHESIS. 



THE very excellent and convincing- article on 
Lachesis by Dr. Lippe in the last number 
of the "Review,"* calls to mind the fact that this 
remedy, so highly prized by many practitioners — 
I might say by all who make any use of it what- 
ever — is, by a large number of homceopathists, 
regarded as of no account at all. 

Those who do not use Lachesis in their practice 
give various reasons for their course. Some express 
the views laid down by Dr. Lippe. These are 
theoretical and a priori objections, and they cannot 
stand one moment against the testimony of experi- 
ence and a posteriori demonstration. 

Others hesitate to use Lachesis because they 
cannot procure it in the "mother tincture," or the 
" first decimal preparations," or in any dilution 
below the sixth. Inasmuch as, by both faith and 
practice, they are committed against "infinitesimals," 
they cannot employ Lachesis in any case, since 
they could not use it in any but an infinitesimal 

* "Lachesis," by Ad. Lippe, M. D. "American Homoeopathic 
Review,'' June, 1863, p. 552. 



244 



LACHESIS. 



dose. No doubt many are sincere in this objection. 
A few, it must be feared, gladly avail themselves 
of so fair a pretext for avoiding the study of the 
long list of symptoms which Lachesis presents. 
It is a pity that this whole class of objectors could 
not bring themselves to the point of fairly testing, 
by clinical experiment, the virtues of Lachesis. 
The result would be happy in a double sense. It 
would enlighten them respecting a most valuable 
remedy, and at the same time it would be a 
satisfactory demonstration of the action of infini- 
tesimal doses. 

A third class of objectors throw discredit on 
the proving of Lachesis, and on very singular 
grounds. Because it is fragmentary ? Scanty ? 
Has but few symptoms ? Is carelessly arranged ? 
Criticisms like these have been made with more 
or less justice upon many provings in our materia 
medica. No ! the objection made to the proving 
of Lachesis is that it is too rich ; there are " too 
many symptoms ; " it is too thoroughly elaborated ! 
" What ! " it is asked, " can one remedy produce so 
many symptoms ? " The answer comes readily to 
hand, — " No ! " The inference is at its elbow, — 
" Some symptoms, then, must be false." Then come 
the conclusions, — "Some are false; we cannot tell 
which they are ; we will therefore reject all, and 
the remedy along with them ! " 

One of the oldest and most widely known 
homoeopathic practitioners in America said to the 
writer: "In the American 'Jahr's New Manual,' 



LACHESIS. 245 

thirty pages are devoted to Lachesis. If all were 
reduced to a concise statement of verified, unques- 
tionable Lachesis symptoms, even Dr. Hering 
would admit that there would not be matter for 
more than three such pages. I therefore reject 
the whole proving and never give the remedy." 

To this objection I could not help replying: 
" In yonder wheat-field, I doubt not the proportion 
of chaff, straw and stubble to good wheat is as 
ten to one. And yet the farmer willingly submits 
to the labor of harvesting, threshing and winnow- 
ing for the sake of the ten per cent, of wheat ; he 
would not think of abandoning the grain in his 
field because of the tenfold preponderance of chaff. 
And if there be, as you admit, in those thirty- 
pages, the equivalent of three pages, or even of 
one page, of verified and trustworthy symptoms, 
how can you, as a conscientious prescriber, delib- 
erately refuse to make yourself master of them 
and to use in your practice the remedy which 
produced them ? " 

This question, which received at that time no 
conclusive answer, addresses itself to all who stand 
in the position of that practitioner. 

If, of the three thousand and more symptoms 
ascribed to Lachesis, there be thirty, if there be 
three, symptoms that are trustworthy and that are 
peculiar to Lachesis, a case of disease may occur 
presenting those symptoms and no others, and 
which, therefore, Lachesis, and no other remedy, 
will cure. How can those gentlemen who deter- 



246 



LACHESIS. 



mine beforehand that they will have nothing to do 
with Lachesis because of the two thousand and 
seventy or the two thousand and ninety-seven 
symptoms which they discredit — how can these 
gentlemen, with a clear conscience, run the risk of 
meeting - such a case and of losing it from the want 
of knowledge of the characteristics of Lachesis? 

The objection to the length and complexity of 
the treatise on Lachesis comes from those who 
have cursorily turned over the leaves of the 
Manual, and not from those who have made an 
earnest study of the symptomatology. The latter 
class of students make no such complaint. They 
find, indeed, no great difficulty in getting a clear 
idea cf the relations of Lachesis to morbid con- 
ditions. And the facility with which they can do 
this is due chiefly to the care with which Dr. 
Hering has elaborated the proving, to the immense 
labor he has devoted to the collation of the symp- 
toms, to" his caution in avoiding any sundering of 
pathogenetic groups, and to his faithful repetition 
of each group under every rubric to which it has 
any pertinence. All these points of excellence, 
while they have made the original proving of 
Lachesis a model for fullness and clearness of 
arrangement, have made its length a bugbear to 
the timid reader. 

But it is not to be supposed that either a pri- 
ori doubts of the efficacy of a remedy, or any 
practical difficulties in the mastery of symptoma- 
tology, would deter physicians from studying and 



LACHESIS. 



247 



using it, when the testimony of those who have 
employed it successfully shall have been placed 
before them. 

In 1850, while assisting in the autopsy of a 
woman who had died of puerperal peritonitis, the 
writer received a dissecting wound _ in the index 
finger of the left hand. Within a week, the finger 
had quadrupled in size, the hand and forearm were 
much swollen and cedematous, a hard, red line 
extended from the wrist to the axilla. The axillary 
glands were swollen. The arm and hand were 
intensely painful ; the whole left side was partially 
paralyzed. The constitutional symptoms were: 
extreme prostration, — causing the disease to be at 
first mistaken for a typhus, — low muttering delirium 
at night, marked aggravation of suffering and 
prostration on awaking from sleep. The general 
condition grew steadily worse, abscesses forming 
under the deep fibrous tissues of the finger and 
hand. No homoeopathic practitioner was in the 
neighborhood. The allopathic surgeons in attend- 
ance advised calomel and opium, but gave a very 
discouraging prognosis. The patient refused to 
take any drugs, determining to trust the issue of 
the case to Lachesis. The first dose (of the 
twelfth) was taken on the third day of the illness, 
and a dose was taken thrice daily for five days, at 
the end of which period the constitutional symp- 
toms had substantially vanished. The recovery of 
the finger was slow but complete. The effect of 
the Lachesis could not be mistaken by the patient. 



248 



LACIIESIS. 



FROM MY CLINICAL RECORD. 

April 9th, i860. Josephine Birmingham, aged 
nine years, well grown, had, last winter, scarlatina 
very severely. It left her delicate and deaf. Nine 
days ago she was exposed to the measles. The 
rash appeared on the 6th inst., along with a copi- 
ous discharge from the ears. Yesterday (8th) this 
discharge suddenly ceased and the rash disappeared. 
She immediately became very feeble and prostrate; 
was seized with wild, muttering delirium. She had 
great thirst, drinking, however, but little at a time. 
There was a singularly biting heat of the skin. 

I saw her first at eleven a. m., on the 9th inst. 
She had lain in alternate delirium and stupor for 
twenty-four hours; was irrational; had low mutter- 
ing delirium ; the pulse was soft, wavy, hardly to 
be counted ; there was calor mordax ; the respira- 
tion was attended by- moaning ; it was very rapid, 
whistling ; there was an occasional single cough, 
with a moan following each cough, and a grasping 
at the throat, as if to tear away the clothing from 
it. The pupils were widely dilated ; there had been 
no stool for two days ; the urine was scanty and 
seldom passed ; I could not secure any for analysis. 
The expression of the countenance was cadaverous; 
the odor of the breath putrescent. I ordered 
Lachesis 3 °, six globules in water, a tea-spoonful 
every two hours. Also strong beef tea every two 
hours. 



LACHESIS. 249 

At six p. m. I found her sitting supported in 
an arm-chair, playing with some toys ; rational ; 
the skin of a pleasant temperature ; the pulse 
eighty, regular and soft. The attendants reported 
that after the second dose she had slept quietly, 
had had no more delirium and no thirst. I found 
the eyes normal, the cough infrequent and not 
painful. I ordered Saccharum lactis. 

The rash did not re-appear. The patient con- 
valesced from this point, and I gave no other 
remedy and did not repeat the Lachesis. 

This change from apparent impending death to 
established convalescence within the space of seven 
hours was very impressive and even startling. 

In the year 1853 there prevailed, quite exten- 
sively, in Brooklyn, an epidemic of what was called 
" malignant pustule." A furuncular formation 
appeared, generally upon the lower lip, attended 
with severe pain, and frequently surrounded by an 
erysipelatous areola. The m@st marked constitu- 
tional symptom was a very rapid and excessive 
loss of strength, the patient being reduced from 
vigor to absolute prostration within the space of 
from twenty-four to thirty-six hours. Allopathic 
physicians at first resorted to the local applica- 
tion of nitrate of silver to the pustule. In those 
cases, thus treated, which came under my personal 
observation, death followed cauterization within 
twenty-four hours. 

In eight cases treated by myself, Lachesis was 
the only remedy used. It relieved the pain within 



25O LACHESIS. 

a few hours after the first dose was given, and the 
patients all recovered very speedily. 

I have three times been called to cases of 
chronic ulcers of the lower extremities (probably 
cf syphilitic origin), in which the discharge had 
ceased ; the extremity had become cedematous, and 
a hard, slightly red swelling extending up along 
the course of the principal veins, together with a 
great and sudden prostration of strength, low 
muttering delirium and general typhoid symptoms, 
gave good reason for supposing that the secondary 
phlebitis had occurred. In these cases a careful 
study of the symptoms induced me to give Lachesis. 
The effect was all that could be desired, the patients 
rallying promptly, all symptoms of phlebitis speedily 
disappearing. 

During the prevalence of diphtheria on the banks 
of the Hudson in 1858-60, many cases occurred 
in which the severity of the constitutional symp- 
toms was very much* greater than the local mani- 
festations of disease in the pharynx would have 
led one to anticipate. In some cases in which the 
tumefaction in the throat was slight, and the red- 
ness of the mucous membrane hardly noticeable, 
and in which the diphtheritic deposits consisted 
merely of two or three little patches hardly larger 
than a pin's head, the prostration of strength was 
quite alarming ; the pulse became, in a very short 
time, slow, feeble and compressed, a cold, clammy 
sweat frequently covered the forehead and extrem- 
ities, the breath was fetid, the appetite entirely 



LACHESIS. 251 

destroyed, — indeed, the patient passed with alarm- 
ing- rapidity into a completely asthenic condition. 
Not infrequently the prostration had become quite 
considerable even before any local evidences of 
disease could be detected. 

In these cases, — in all in which the constitu- 
tional symptoms thus predominated over the local 
symptoms, — Lachesis produced prompt and lasting 
improvement, so that very rarely was any other 
medicine given subsequently. 

Several cases of carbuncle have come under my 
notice, in which the progress of the inflammation 
was very slow, the skin over the dead cellular 
tissue showed little disposition to ulcerate, and 
when, finally, it became perforated in three or four 
places, there was but a scanty discharge of thin, 
sometimes bloody, sanies. Meanwhile the constitu- 
tional symptoms denoted very great prostration, 
not preceded nor attended by the nervous and 
vascular erethism which are sometimes observed in 
similar cases. Lachesis is the remedy on which 
experience has taught me to rely in the treatment 
of such affections, provided the symptoms do not 
conclusively indicate some other remedy. In the 
cases to which I refer, the symptoms corresponded 
very closely to those of Lachesis. 

About a year ago, I was called to take charge 
of a patient who had suffered for several years 
from a succession of carbuncles and indolent boils. 
During the four months preceding my visit to him, 
he had had four successive carbuncles, none of 



252 



LACHESIS. 



which ran a complete course. After the skin 
covering" the dead cellular tissue had become per- 
forated, a slight discharge of sanies had taken 
place, and the perforations .had closed again, with- 
out any discharge of slough, leaving an indurated 
mass, with a dull, burning pain and considerable 
tenderness, but scarcely any discoloration. After 
each of these carbuncles, a marked deterioration 
in the patient's health was observed, until, after 
the last, he was so much reduced as to be confined 
to his bed, with well-marked hectic fever. 

Pretty soon, a severe pain in and below the 
right groin and along the inner aspect of the 
femur, gave indication of trouble in that region. 
An abscess was discovered deep in the adductor 
muscles of the thigh. An opening was made by 
a distinguished professor of surgery in New- York 
upon the anterior surface of the thigh (as the 
patient was confined to the bed and lay on his 
back, this was the superior aspect of the thigh), 
and nearly a quart of pus was discharged. The 
formation and discharge of pus continued to be 
profuse for fifteen days, the patient all the time 
becoming rapidly more feeble, with severe hectic, 
total loss of appetite, and great local suffering, 
when the case was placed under my charge. I found 
that the evacuation of the pus was a very difficult 
matter, the aperture being at the highest point of 
the abscess. The attending surgeon had been 
compelled to withdraw the pus by means of an 
exhausting pump, attached to the free end of a 
gum catheter which he previously introduced into 



LACHESIS. 253 

the abscess. I continued this method until the 
abscess closed. The patient, his family, and the 
physicians in attendance had abandoned all hope 
of his recovery. 

In view of the copious formation of pus, one's 
first thought would naturally be that Silicea would 
be the appropriate remedy. This remedy, however, 
had been given in every variety of potency. It 
had never failed to aggravate the whole condition 
of the patient, without any subsequent benefit. 

Considering, now, the history of the patient — 
the long succession of boils and carbuncles, the 
four aborting carbuncles, each followed by a marked 
deterioration of health, and each leaving a painful 
induration which might be supposed to be a por- 
tion of dead cellular membrane retained in contact 
with the living tissues, and that the present abscess 
had followed immediately upon the last of this 
series of abortive carbuncles, very much as a 
secondary abscess follows the absorption of pus in 
pyaemia — I resolved to trust the case to the action 
of Lachesis. At the same time, I informed the 
patient that, in my judgment, after the healing of 
the abscess, the indurated remnants of the four 
aborted carbuncles would inflame again and be 
discharged, and that this process must precede the 
re-establishment of his health. 

I gave a dose of Lachesis 200 every morning, 
noon and night. The progress of the case was 
tedious, but uniform and prosperous. In twelve 
days the hectic had ceased, the appetite was 
restored, and the formation of pus had decidedly 



254 



LACHESIS. 



diminished. In six weeks the abscess had healed. 
In seven weeks the patient walked on crutches. 
But now, when he seemed almost well, fever came 
on again and he was prostrated. After twenty-four 
hours of fever, the indurated remnant of the last 
carbuncle became inflamed, an abscess formed and 
a slough was discharged. The same thing occurred 
in the locality of the three remaining indurations, 
and, singularly enough, in the inverse order of their 
original appearance. After the last of these 
abscesses had healed, the patient rapidly gained 
health and strength, and has since been perfectly 
well. In this case no remedy was given save 
Lachesis 200 . When the treatment was beeun, the 
patient was in a most deplorable condition, and his 
recovery was hardly hoped for by his attendants. 
Improvement began as soon as he began to take 
Lachesis, and continued, with scarcely an interrup- 
tion, until he was completely restored. 

Now, let us suppose that to a man in perfect 
health there be administered daily a dose of a 
drug, which, a person familiar for some years with 
its properties predicts, will cause the man to exhibit 
a definite series of symptoms and finally to die. 
As soon as the administration of the drug is begun, 
the man begins to exhibit the predicted symptoms, 
and finally, as was foretold, he dies. What jury, 
with these facts before it, would hesitate to say 
that the man was deliberately poisoned, and to 
convict the one who gave the drug of murder ? 
Now, shall not such evidence as would convince a 
jury of citizens that a man has been poisoned by 



LACHESIS. 



255 



a drug, convince a body of physicians that a 
patient has been cured by Lachesis ? Shall not 
testimony that would hang a malefactor convert a 
skeptic ? 

The diseases which I have cited as these in 
which Lachesis has been of unquestionable service 
in my hands, present, in name at least, a con- 
siderable variety. Pysemia, repercussed measles, 
malignant pustule, diphtheria, phlebitis, carbuncle, 
have not necessarily a great deal in common. A 
close examination, however, of the cases as I have 
described them, will show, notwithstanding the 
diversity in name, a considerable approach to iden- 
tity in morbid condition. In all there was great 
prostration, as manifested by loss of muscular 
power, slowness and softness of pulse, stupid 
delirium, etc. In this respect the cases resembled 
those in which Arsenicum is indicated and has so 
often proved curative. These cases, however, did 
not present that vascular and nervous erethism 
conjoined with prostration, which is so characteristic 
of Arsenicum. Nor, on the other hand, was the 
asthenia so complete as to call for Carbo vegeta- 
bilis. Lachesis may perhaps be held, in so far as 
the symptoms of asthenia are concerned, to occupy 
an intermediate position between Arsenicum and 
Carbo vegetabilis. This statement would at once 
suggest its usefulness in typhoid fevers ; and those 
who have made themselves familiar with Lachesis 
have learned from clinical experience to place great 
dependence upon it in treating certain forms of 
these diseases. 



LYCOPODIUM CLAVATUM. 



SENSORIUM. Verti go, occurring particularly in 
the forenoon, and in a hot room; accompanied 
by nausea ; it seems as though everything were 
turning around. 

The perceptive faculties are singularly affected. 
One cannot read, because the meaning of certain 
letters is not clear; errs in speaking, because he 
cannot get the right words ; this when talking 
about every-day matters ; whereas when the subject 
is very important, so as to call forth the most 
energy, the words are correctly chosen. Analogous 
to the state of mind in certain typhoid conditions. 

Generally it is difficult to collect and hold the 
thoughts. 

Head. Confused ; heaviness. 
Headache; often semi-lateral. A shattered or 
concussed sensation at every step. China ; Rhus. 

Often a semi-lateral headache, especially at 
evening, much aggravated by reading or writing. 

Pain over and between the eyes, early in the 
morning. 

There are also pressing and throbbing pains in 
various parts of the head. The most frequent is 



LYCOPODIUM CLAVATUM. 



257 



an aching pressure in the occiput, or over the 
eyes. 

The head easily becomes cold, which results in 
a cutting soreness of "the scalp. The hair becomes 
gray, and falls out. Consider, in this relation, the 
eruptions of Lycopodium. 

Complexion. Pale, sallow ; sunken eyes and 
blue rings around them. 

Eyes. Dazed by light, and painful as if bruised. 

They present many symptoms of inflammation, 
as redness and swelling of the eyelids, with aching 
pains, ulceration and nocturnal agglutination ; itch- 
ing in the canthi and much lachrymation. 

In the eyes themselves, redness, aching and 
burning and stitching pains. 

Vision is affected ; in artificial light all objects 
tremble ; a constant flickering, or black spots 
before the eyes ; vision obscured ; letters run 
together or are indistinct ; one must vary the dis- 
tance of the book from the eye. 

Ears. Tearing or stitching pains in the meatus, 
with the sensation that it is too narrow. The open 
air provokes a kind of earache. 

Itching in the ear, and discharge from the 
meatus. 

Roaring, buzzing, etc., in the ears. 

Deafness : sometimes over-sensibility to noise, 
while walking. 

Nose. Externally, pressure and aching. Inter- 
nally, soreness. 

Frequent epistaxis. 
II.— 18 



LYCOPODIUM CLAVATUM. 



Sense of smell keen ; sometimes perverted. 

Mouth. Gums swollen, hot and tender. Jump- 
ing toothache, relieved by warm drinks. (Relieved 
by cold water indicates Coffea. Hahnemann.) 
Sometimes the toothache comes on from the 
slightest touch to the teeth or from the shock of 
coughing. Sometimes only at night, and causing 
great nervousness. 

Tongue. Sore ; ulcers under it, paining when 
speaking and eating. Dryness in the mouth and 
throat, with and without thirst. 

Throat. Diseases of the throat that begin 
on the right side and go to the left. (Lippe.) 
Lachesis has the reverse. Tearing" and aching in 
the throat. The uvula is swollen. The glands 
are swollen, and are the seat of stitching pains. 

Digestive Apparatus. The mouth is dry; bitter 
taste, in the morning or all day ;* but food has its 
natural flavor. Sometimes a sweet or even a sour 
taste. 

Heart-burn. A burning sensation comes up 
from stomach to throat, with a sour taste in the 
mouth ; sometimes so violent as to take away the 
breath. Or a kind of incomplete burning eructa- 
tion which comes as far as the pharynx and leaves 
a burning in the throat. 

Empty, sour eructations, especially after each 
meal ; with gulping up of digested food. 

Water gathers in the mouth, with nausea. 

These are the symptoms of slow and enfeebled 
digestion. 



LYCOPODIUM CLAVATUM. 



259 



Every morning-, on rising, nausea, and water- 
brash, with oppression of the chest, heat in the 
abdomen, and cold face. 

Appetite fails. No thirst. (Constant sense of 
satiety.) 

After eating, oppression cf the stomach and 
bitter taste. The abdomen is in a ferment. Also, 
after eating only a very small quantity, a sudden 
feeling of satiety and even of fullness in the epigas- 
trium, with flatulent rumbling in the bowels. This 
is characteristic of Lycopodium. Sepia alone has 
the same symptom. Acidity and heart-burn with 
constant sleepiness after dinner. 

Stomach and other digestive organs. After eat- 
ing and after slight cold, violent stomach pains 
with chilliness, the fingers becoming waxy white, 
as if dead. The gastralgia is like a constriction, 
or a gnawing, and the patient cannot bear any- 
thing tight around the epigastrium. 

In the liver region, frequent pains and tender- 
ness to pressure. 

The chief sensation under Lycopodium is aching 
pressure, and we find this produced in stomach, 
epigastrium and liver, with pain on pressure and 
deep respiration. 

I have found in a case of chronic duodeni- 
tis, relieved by Lycopodium, always present this 
symptom : pressure on the hypochondrium pro- 
duced tender pains in the epigastrium, and vice 
versa. 

Especially often the aching pressure in the 



260 



LYCOPODIUM CLAVATUM. 



region of the liver, like a dull and tensive aching 
and pressure, on respiration, on bending the body, 
or on pressure with the hand. Sometimes this 
extends to the left side of the abdomen, and some- 
times down to the hip. 

In the abdomen, squeezing pressure, so severe 
one cannot walk erect, but must go bent over or 
lie down ; it produces dyspnoea. 

Tensive, tearing and cutting pains. 

The great characteristic of Lycopodium is the 
production of flatus in the intestines. 

The abdomen is distended thereby ; flatus 
becomes incarcerated in the abdomen, producing 
pain, finally relieved by eructations. Tension and 
rumbling in various parts of the abdomen. It 
appears that most of the abdominal pains of Lyco- 
podium are due to flatus. 

Pains in the region of the abdominal ring, 
outward pressing ; and the old hernia protrudes. 
Swelling of the inguinal glands, which pain as 
though suppurating. 

About the anus, itching and a moist, tender 
eruption. Aching and pressure in the rectum, 
especially at night. Stitching and burning at stool, 
even when the faeces are not hard. Haemorrhoids 
swell and protrude and bleed, even when there is 
no constipation. 

Inclination to stool, but at stool a spasmodic 
pain or constriction of the anus, which makes the 
evacuation difficult. It is scanty, infrequent and 
difficult. After stool, much rumbling in the bowels 



LYCOPODIUM CLAVATUM. 



26l 



and either flatulent distention of the abdomen or 
uterine cramps, or great lassitude. 

Urinary Organs. Secretion diminished. Urine 
dark, with a yellow or reddish deposit. " Red 
sand in the urine. Terrific pain in the back 
before every urination, relieved by urinating." (G.) 

Smarting and burning, when passing water, in 
the female urethra; and stitches or drawing or 
cutting pains through the urethra and toward the 
abdomen. Painless discharge of blood throueh the 
urethra. 

Sexual desire and power diminished markedly 
in males. 

The menses anticipate a little and are too 
profuse ; preceded by flatulent distention of the 
abdomen ; great heaviness of the legs ; chill 
and heat at night; ill humor and disposition to 
weep. 

During the menses, acid taste, headache, severe 
backache ; swelling of the feet, nausea and a kind 
of faintness. 

Leucorrhcea in spells; of a blood-red color; 
"with cutting pains going across the body from 
right to left." (G.) 

Respiratory Organs. Fan-like motion of the 
alae nasi (Dr. D. Wilson's indication in severe 
pneumonia). Catarrhal conditions. Frequent sneez- 
ing. Coryza, both dry and fluent. When dry, 
oppressing respiration, with burning headache. 
When fluent, with swelling of the nose and copious 
acrid and offensive discharge. 



262 



LYCOPODIUM CLAVATUM. 



The cough is provoked by a tickling irritation 
in the larynx, as if from vapor of sulphur. Some- 
times dry ; and, when so, very fatiguing, producing 
pain in the head, stomach and abdomen ; some- 
times loose, the sputa being a thick gray, grayish 
yellow, or yellow, or mixed with blood and having 
a saltish taste. These and other symptoms have 
led to the successful use of Lycopodium in con- 
sumption, etc. 

In the chest, a sensation as if the lungs were 
full of mucus, with a whistling sound in the trachea 
on inspiration ; a fullness and oppression in the 
open air and after eating. 

Aching, with or without soreness, producing 
some dyspnoea and much mental depression. Tear- 
ing and tension under the clavicles, and stitch on 
deep inspiration. 

Externally, stitches and burning pains in the 
nipples and discharge from them of blood and 
water; hence Lycopodium in sore nipples, etc. 

Back. Backache so severe that it makes it 
impossible to sit, and the pain even extends, as a 
constrictive sensation, to the chest. 

Tearing in the sacrum, kidneys and back, espe- 
cially near the spine. Drawing and aching between 
the scapulae. 

The aching in the kidneys is increased before, 
and diminished after, urinating. 

In the extremities, we find tearing and aching 
pains ; and more frequently during repose than 
motion. Pains, tearing, etc., from the neck to the 



I 



LYCOPODIUM CLAYATUM. 263 

shoulder and elbow, especially at night and during 
repose ; also in the whole arm to the wrist ; in 
the hand and ringers while they are in bed, 
but ceasing when they are taken out of bed. 
Tearing and aching in the joints and ends of 
the fingers, with burning and sometimes itching 
of the palm. Consider these symptoms in connec- 
tion with the red deposit in die urine. (Rheumatic 
gout?) 

In the lower extremities the same pains about 
the hips, in the nates ; down the thigh and legs ; 
under the heel and in the toes. 

A paralytic weakness is often felt in the arms ; 
as though they would fall by the side; yet they 
are strong enough in work. 

The same sensation in the limbs. 

The limbs go to sleep easily. 

Every four days a pain in the leg from the hip 
to the foot, causing limping. (Verified.) 

Intertrigo. The finger joints are red, inflamed, 
swollen ; and burn and pain. 

Swelling of the feet and limbs. (Dropsical.) 

Feet cold, with cold sweat, which makes them 
sore. 

Sleep. Fruitless efforts to yawn (like chloro- 
form). Great day sleepiness, but late sleeping at 
night. Restless ; wakes often with vivacious, trou- 
blesome dreams. Starting on falling asleep. Tired 
on waking in the morning. 

Fever. Chill predominates ; comes more in the 
evening ; not much heat, nor sweat ; generally 



264 



LVCOPODIUM C LA VAT (JM. 



every second day, often affecting only one side of 
the body. 

Sometimes the sweat follows the chill without 
intervening heat ; or the chill and heat are mixed up. 

Sweat mostly on the chest and trunk ; at night 
or early in the morning. 

Lippe says: " Night sweats cold, clammy, sour, 
fetid, bloody, smelling like onions." 

Disposition. Great anxiety ; timidity ; fears to 
be alone. 

Also indifference to external influences. Depres- 
sion ; sadness; inclined to weep. " Great fear of 
being left alone." 

Weakness : bodily ; mental ; moral. 

Skin. Red, itching and burning, or painless 
spots of eruption. 

Eczematous, suppurating eruption on the head, 
with swollen cervical glands. 

Dark red spots and blotches on the face, sup- 
purating. Fine eruption about the mouth and on 
the chin. Warts on the fingers and hands. Inter- 
trigo ; especially between the thighs and on the 
scrotum ; also, under the arms. 

Compare Carbo animalis and Calcarea sul- 
phuris. 

Stiffness in the limbs and joints, and great 
weakness. 

Generalities. The pains are aching, — pressive, 
drawing and burning. 

Restlessness, and excited circulation in the 
evening, producing a feeling of trembling. 



LYCOPODIUM CLAVATUM. 



265 



Ulcers that are present bleed when bandaged, 
and have a stitching pain. 

The symptoms are worse from four to eight p. 
m., and recur regularly ; as do those of Sabadilla. 

Lycopodium affects the mucous membranes of 
the respiratory, digestive, and genito-urinary organs; 
makes digestive processes slow; hence wind, water 
and acidity. 

Produces lithic acid deposit in quantities ; hence 
pains in the kidneys and bladder, etc. ; and hence 
indirectly the pains in the limbs and joints. Pro- 
duces catarrhal condition, and muco-purulent sputa. 

Nervous action weakened ; a great remedy for 
overworked brains and where brain trouble, for 
e. g. t softening, threatens from overwork or from 
metastasis of ulcers suddenly healed ; see the tor- 
por ; the use of wrong words ; failure to collect 
and command the thoughts, etc. 



NATRUM MURIATICUM. 




HIS remedy cannot often, in chronic cases, be 
repeated without an intercurrent. 



Head. Vertigo ; when walking, everything goes 
round in a circle ; when sitting quietly with a 
downward pressure of the head ; when rising from 
the bed. 

Sensorium. Absence of mind; incapacity; con- 
fusion of ideas ; does not know what to say ; slow 
in coming- to a resolution ; indecision. 

Memory much weakened ; forgets what he 
would write ; cannot remember what happened 
yesterday. 

Head. Confusion, as after much mental exertion. 

Headache produced by quick movements of the 
head, sudden turning, etc. 

Heavy aching (pressure) in the forehead, with 
pressure outward in the eyes. Pressure inward on 
both temples, as if the head were in a vise ; or a 
fullness, as though the head would burst, increased 
by reading or writing ; often accompanied by 
nausea; worse in the afternoon. 

But such a headache succeeds the chill of febrile 



NATRUM MURIATICUM. 



267 



paroxysm, and then comes in the morning. Throb- 
bing also during the fever. 

The scalp is cold, and chills run over it. 

Itching. The hair falls out when touched or 
combed (common in nursing women, and Natrum 
muriaticum stops this). 

Complexion. Sallow, earthy, yellow, with pain 
in the abdomen (torpid chlorosis). 

Eruptions. Miliary eruption on the forehead, 
perceptible to the touch only. Papules on the 
cheeks and chin. 

Aching around the eyes, in the malar bones 
and zygomatic arch. The eyelids quiver and 
twitch, are ulcerated and red, with soreness and 
agglutination. Hordeola are frequent. 

The eyes itch, especially in the inner canthus ; 
or ache. Conjunctiva reddened, and burns on slight 
exposure to the wind, with acrid lachrymation. 

Vision obscured, as if the eyes were covered 
with mucus or a thin veil. Half vision ; one side 
of the object is distinct, the other side looks 
dark (Lithium). Also, accommodation is modified, 
myopic or presbyopic. Fiery points before the 
eyes. Aggravation from using the eyes in read- 
ing, etc. 

Ears. Heat of the external ear; swelling of 
the meatus and discharge of matter ; much itching, 
both internally and externally. Drawing and 
stitching pains from the ear down the neck to the 
shoulder ; or from the teeth up to the ear. Noises 
in the ear; rushing and ringing. Deafness. 



268 



NATRUM MURIATICUM. 



Nose. White papules at the root of the nose. 
Alae nasi inflamed, with redness, heat and swelling, 
and great soreness. One-half of the nose becomes 
insensible and as if dead. Epistaxis from stooping, 
but especially on coughing and at night, with sore- 
ness in all the limbs. 

Lips. Swelling, with vesicles ; also vesicles on 
the tongue, which burn and smart and, finally, have 
a scab on them. The lips crack. Pain in the 
submaxillary glands, as if swollen or compressed ; 
and on coughing. 

Gums. They bleed easily, are sensitive to cold 
and warmth, and to pressure with the tongue. 

Teeth. Very sensitive ; toothache on drawing 
the air against the teeth, and on pressure of the 
tongue and of food. They become loose. 

Drawing pain from the teeth, extending to the 
ear ; extending throughout all the teeth. The pain 
extends into the malar bones. 

Tongue. Heavy and clumsy, as if paralyzed. 
Can only speak with much effort. One-half of 
the tongue seems numb and stiff. 

Burning and sore vesicles on the tongue ; also 
on the gums ; very sensitive to contact of food. 

In the throat, some stitching sensation behind 
the tonsil, and a sense of constriction. 

Digestion. Sense of taste blunted or annihi- 
lated ; sticky or bitter taste ; water-brash. Nausea 
frequent, especially early in the morning, with pros- 
tration after eating or drinking even agreeable 
things ; first food, then bile. 



NATRUM MURIATICUM. 



269 



Abdomen. Stitches in the right hypochondrium 
and stomach ; also in the left hypochondrium 
on deep inspiration and on bending- to the left 
side, which also produces a sense of .stiffness in 
the liver. Tension in both hypochondria. 

Pinching in the hypochondria. Cannot lie on 
the sound side; also in the umbilical region and 
thence into the sacral region, and into the rectum 
and anus. Distention of the abdomen, and much 
flatus. Herniae protrude. 

Stool. Insufficient; frequent, ineffectual efforts; 
great exertion is necessary to evacuation ; often 
blood follows. 

Tenesmus in the rectum, with discharge of 
flatus and slime. The rectum seems constricted, 
and it is only after great effort that some little hard 
faeces pass, which tear the anus so that it bleeds 
and smarts ; and then comes some dirty water. 
Stool preceded by pressure in the region of the 
bladder ; soreness in the abdomen, accompanied by 
labor-like pains in the abdomen ; pressing-down 
pain, followed by tenesmus ; vain efforts, and sen- 
sation as though diarrhoea would ensue ; burning 
and smarting soreness in the anus. 

Beside this, stitches in the rectum and anus ; 
violent pains in the bladder and anus ; prolapsus 
ani, with bloody mucus and water ; and burning, 
preventing sleep at night. 

Urinary Organs. Urination almost involuntary 
after violent tenesmus. Pressure on the bladder, 
and stitching pain. Cutting and burning after 



270 



NATRUM MURIATICUM. 



urination ; and discharge of thin mucus, leaving 
translucent spots on the linen. Urine clear ; 
deposits of urates, white or red, or red sand. 

Sexual Organs. Male. Frequent pollution, 
followed by cold exterior and lassitude. Sexual 
desire increased. Gonorrhoea. 

Female. Menses retarded and less in quantity, 
or delayed and weak two or three days, and then 
a copious flow. Preceded by anxiety and disposi- 
tion to faint, or nausea, with sweet taste and 
bloody sputa ; accompanied by constipation, or 
tearing toothache ; followed by dull headache. 
Leucorrhcea copious, with bearing down as if the 
menses 'were coming. 

Respiratory Orga.ns. Dry catarrh of the larynx 
and trachea. Voice hoarse. 

Sneezing. Coryza, although dry and somewhat 
loose, impedes respiration very much. 

Cough, provoked by tickling in the epigas- 
trium, day and night ; increased at night or early 
in the morning. Generally dry, with wheezing and 
vomiting and headache and soreness in the larynx 
and trachea. Vague pains in the thorax. The 
heart's action is affected. Palpitation, forcible and 
anxious, with aching as if a pressure came from 
the abdomen and compressed the heart ; increased 
by lying on the left side and on every motion ; 
palpitation and fluttering. 

Back. In the sacro-lumbar region, pulsation 
and stitches ; a paralytic soreness, increased in the 
morning on rising ; cannot stand erect nor walk ; 



NATRUM -MURIATICUM. 



271 



diminished when lying down. Soreness in the 
loins, as if beaten ; also in the back and between 
the scapulae. In the back, tension and stiffness. 
Tearing. Burning in the scapulae, as from hot 
water. 

In the extremities, a marked feeling of lassitude 
and weakness ; cannot raise the arms or lift any- 
thing ; can hardly move them. 

The same in the lower extremities. 

Sleep. By day sleepiness. Sleeplessness at 
night ; restlessness. Dyspnoea. 

Fever. A full and powerful paroxysm complete, 
occurring early in the morning ; a severe chill, 
then frontal headache, red face and high fever ; 
sweat in the evening. 

Professor Guernsey says : 

" Thirst for large quantities of water before the 
chill ; this thirst continues through the paroxysm. 
Violent chill with headache, and after the chill the 
headache increases greatly ; feels as if the brain 
were being beaten with thousands of little ham- 
mers. After the fever, sweat, and the patient 
wishes to lie a long time. If the disease lasts 
long, the corners of the mouth become sore, and 
finally the lips." 

Disposition. Impatient and hasty. Easily 
angered. Then melancholy ; sadness ; anxiety. 



VERATRUM ALBUM. 



WHITE HELLEBORE. 



HE root of the plant is used in medicine. It 



JL may be prepared by trituration, or used in 
the form of a tincture. 

It was known to the ancients, and was used by 
them to cure insanity and various spasmodic affec- 
tions ; and it is recorded of Hippocrates that he 
cured with it a case much resembling Asiatic chol- 
era, as follows: 

"A young Athenian, affected with cholera, 
evacuated upward and downward with much suffer- 
ing ; nothing could arrest the vomiting or alvine 
evacuations. His voice failed ; he could not stir 
from bed ; his eyes were lustreless and sunken ; he 
had convulsions of the lower extremities from the 
abdomen downward ; he had hiccough, and the 
alvine dejections were more copious than the 
vomitings. He took Veratrum in lentil-juice and 
recovered." This was a most excellent homoeo- 
pathic prescription. 

The action of Veratrum on the vital force is 
but moderate in so far as the sensorium and the 
nerves of animal life are concerned, but in so far 




VERATRUM ALBUM. 



2 73 



as the system of nutrition is concerned it is most 
profound. The entire system of vegetation is 
affected in such a way, and to such a degree, that 
it seems as though the body were in a great 
measure withdrawn from the control of the vital 
forces, and given over to the action of mechanical 
and chemical laws. 

The blood tends to separate into its proximate 
constituents, as it would do if suddenly withdrawn 
from the body; the liquid constituents seem to 
filtrate in a half-mechanical manner through the 
tissues, and thus we have a copious cold, clammy 
sweat ; copious serous vomitings and diarrhoeas ; 
evacuations that are astounding from their quantity 
and from the mechanical manner of their ejection ; 
the stomach seeming to become completely filled, 
and to be emptied by a sudden convulsive effort 
provoked by its complete distention. 

This, then, is the key to the pathological char- 
acter of the Veratrum disease — torpor of the 
vegetative system, with comparatively slight affec- 
tion of the system of animal life. 

As might be inferred from the above, the fever 
of Veratrum is characterized by predominant and 
sometimes exclusive coldness. The sweat is cold 
and clammy, and it is notably characteristic that 
almost every important symptom of Veratrum, 
wherever produced, is accompanied by cold sweat 
of the forehead. 

As a matter of course, among the symptoms of 
Veratrum great weakness occurs. It is to be 
II.— 19 ' 



VE RAT RUM ALBUM. 



observed, however, as distinguishing Veratrum from 
Arsenic, that this weakness is not disproportioned 
to the other symptoms, is not unexpectedly great, 
and is not more than might be expected from the 
symptoms of diarrhoea, vomiting, or general dis- 
turbance which mark the case. Neither are the 
symptoms attended by the restlessness, anguish 
and intolerance of pain which are so characteristic 
of Arsenic ; nor indeed do the symptoms involve 
a great amount of pain. That which is felt is 
philosophically endured. The patient is quiet. 

It must not be inferred from what has been 
said that Veratrum exerts no action whatever upon 
the sensorium. On the contrary, it produces a 
kind of mania; and Hahnemann affirms that it is 
a most precious and indispensable remedy in the 
treatment of various forms of mania and insanity. 
Moreover, he found it an indication for Veratrum 
if various kinds of pain were accompanied, now 
and then, by a kind of temporary or transient 
delirium or mania. 

The affection of the mind and disposition is as 
follows : A kind of busy restlessness, a hurried 
and driven feeling that induces one to undertake 
a great variety of labor, which, however, he has 
no heart to finish. Still more common, however, 
is a gentle melancholy, a disposition to weep, and 
an inconsolable grief over an imaginary mishap, 
which cause the patient to sit weeping and not to 
be comforted, or else to run crying and howling 
about the apartment. This condition ends in a 



VERATRUM ALBUM. 



275 



raving mania, with cursing and scolding, endeavors 
to escape, biting and tearing everything and every- 
body that offer opposition ; accompanied by foolish 
imaginings. 

Veratrum produces vertigo. 

The headache is a pressure upon the vertex, 
generally attended by pain in the stomach. It is 
noteworthy that this pressing pain of the vertex 
is relieved by pressing on the vertex with the 
hand. I know but one other remedy of which the 
pressing headache in the vertex is thus relieved, 
viz.: Menyanthes trifoliata. The headache of Men- 
yanthes is accompanied by icy coldness of the 
hands and feet. 

The pupils contract. The sight becomes weak. 
Double vision is observed ; and black spots and 
sparks appear before the eyes. 

The eyelids are dry ; the upper lid seems par- 
alyzed, the patient cannot raise it ; ptosis occurs, 
and has been cured by Veratrum (like Sepia). 

The face is cold, the features are distorted, the 
complexion" is cyanotic. The face is covered, par- 
ticularly the forehead, with a cold, clammy sweat, 
during the symptoms of the stomach, bowels and 
chest. 

The digestive organs are eminently affected by 
Veratrum. 

We notice first an aversion to warm drinks, 
and a longing for fruit and for acids. The taste 
is diminished, or there is a feeling of coolness in 
the mouth, such as peppermint produces. 



2 y6 VERATRUM ALBUM. 

Nausea occurs, often with a taste as of bile in 
the mouth; sometimes it is felt after breakfast and 
ceases after taking dinner. 

The matters vomited are food or green bile, 
and tenacious mucus ; the vomiting is preceded by 
a general shudder, and the nausea continues during 
the intervals between the vomitings. The vomiting 
prostrates the patient, but not more than the quan- 
tity and violence would lead one to expect. 

Pressure in the epigastrium, extending to the 
sternal and hypochondriac regions, and down to 
the os ileum. Pinching, tensive, cutting pains, as 
if the intestines were cut with knives, and with 
this pain diarrhoea is associated. 

In the inguinal regions, frequently, a sensation 
as though a hernia would protrude ; and when 
coughing, a sticking pain along the inguinal canal. 
These symptoms have caused a successful use of 
Veratrum in hernia. 

As regards stool, we find two different condi- 
tions : 

1. Constipation, characterized by a disposition 
to stool in the upper part of the intestinal canal, 
but an indisposition, sluggishness or apparent inac- 
tivity of the rectum and lower intestine. It is a 
most useful remedy in obstinate constipation when 
Nux vomica has failed to relieve, and especially in 
the constipation of infants. 

2. Diarrhoea, watery, light-colored. Sometimes 
colorless, very copious. 

It is characteristic of the vomiting and diar- 



VERATRUM ALBUM. 



rhcea of Veratrum, but particularly of the vomiting, 
that they are provoked by taking liquid into the 
stomach, which is no sooner taken than rejected. 
This is equally true of cold and warm drinks. 
Phosphorus, on . the other hand, has nausea, relieved 
by cold drinks : which, however, are vomited as soon 
as they become warm in the stomach. The gastric 
symptoms of Veratrum are aggravated by motion. 

The vomiting of Tabacum is relieved by eating 
or drinking. 

The vomiting and diarrhoea of Veratrum being 
sudden and copious, are accompanied by exhaustion, 
cold sweat, a pinched, shriveled and livid aspect of 
the face and hands, and loss of voice ; but by no 
great mental or sensorial disturbance, no great 
depression of spirits or anxiety. 

The menses are hastened and increased. 

Veratrum produces a catarrhal condition of the 
nasal membrane, with incessant sneezing and a 
tickling- in the trachea, which extends thence 
through the bronchi to their extremities. The 
cough is generally dry, and if so, it is induced by 
the least motion of the body, or by going from a 
cold into a warm atmosphere. The opposite of 
Rumex crispus. 

Sometimes the cough is loose, and it is then 
accompanied by constriction of the chest. 

Sometimes the slightest bodily exertion pro- 
duces dyspnoea and palpitation. 

Pains, stiffness and lassitude in the trunk and 
back. 



278 



VERATRUM ALBUM. 



In the extremities, lassitude ; and in the lower 
extremities a kind of paralysis, as from too long 
a walk. Besides this, tonic cramps in the calves 
and thighs. 



PRACTICAL APPLICATIONS. 

It is useful in intermittent fever, when coldness 
predominates. The symptoms which call for it 
are, especially, great weakness and prostration ; 
actual sinking of the forces ; very slow pulse, and 
the impulse of the heart very weak, during the 
apyrexia as well as during the paroxysm, but 
especially during the latter ; cramps in the limbs, 
and especially in the stomach and abdomen ; 
paralytic sensations ; syncope ; watery diarrhoea, or 
obstinate constipation depending on inactivity of 
the rectum ; collapse ; cyanosis. 

The cold stage always predominates, and indeed 
often overshadows and extinguishes the hot stage. 
The changes of temperature are most marked in 
the extremities. 

The hot stage often fails entirely, and it never 
reaches a high grade ; generally it consists rather 
in a subjective sensation of warmth while the 
objective temperature is hardly elevated, nay, is 
sometimes diminished. The pulse is but slightly 
accelerated ; it becomes somewhat more frequent, 
but not fuller nor harder. 



VERATRUM ALBUM. 



279 



The thirst is proportioned to the amount of the 
excretions. 

The sweat is cold and clammy. It comes even 
before the paroxysm ; lasts until the next. The 
results of the abuse of Quinine often require 
Veratrum. 

The same general characteristics indicate Vera- 
trum in typhoid and typhus fevers. 

The use of Veratrum in cholera, in diarrhoea, 
in hernia, in constipation, and in bronchitis, has 
been alluded to and the indications have been 
noticed. 



HEPAR SULPHURIS CALCAREUM. 



LIVER OF SULPHUR. IMPURE CALCIC SULPHIDE. 

THE "liver of sulphur" of the shops and of 
the British and United States pharmacopoeias, 
is a sulphuret of potassium, or a potassic sulphide, 
being prepared with potash and not with lime. It 
should never be used to prepare the drug known 
in the homoeopathic pharmacopoeia as Hepar 
sulphuris. It was discovered, in the course of 
experiments, that it produces solubility of sulphur. 
It is prepared by fusion ; sulphur one part and 
carbonate of potash four parts. It is used to 
resolve exudations, as in swollen glands, etc. ; it is 
also used in obstinate skin diseases, and in the 
preparation of sulphur baths. (Balneum sulphura- 
tum of Raye.) Care must be taken if an acid 
is added, because then sulphuretted hydrogen is 
evolved, and there is danger of asphyxia. 

Dupuytren added glue to the bath, and made 
the Balneum sulphuratum et gelatinosum. 

Hahnemann prepared Hepar sulphuris as follows: 
" Equal weights of the interior of the oyster- 
shell and pure sulphur flowers which have been well 



HEPAR SULPHURIS CALCAREUM. 28 1 



washed and dried ; mix well, and place in a well- 
heated porcelain crucible ; cover and keep at a 
white heat for ten minutes. When cold, open the 
crucible and preserve in well-stoppered bottles." 

It is prepared for use by trituration up to the 
third centesimal or higher. 

Some physicians use the third only of Hepar 
sulphuris who use higher potencies of other drugs. 



SPECIAL ANALYSIS. 

Sensorium. Vertigo when shaking the head 
or from jarring, as, for example, from driving in a 
wagon, so that on getting out one cannot stand 
alone. Sometimes faintness accompanies it. 

Head. The pains are aching, boring, and sore- 
ness as if beaten. 

As regards locality, the pain is in the temples, 
forehead and sides of the head, and is sometimes 
confined to one side of the head, — a kind of 
megrim. 

As regards the time of day, the early morning 
and the forenoon are the favorite times of head- 
ache. 

As regards conditions, motion and rising from 
a stooping posture produce or increase the pains ; 
also moving the eyes increases the boring pain at 
the root of the nose. 

To recapitulate, we find : 

Aching pain in the temples and in one-half of 



282 



HEPAR SULPIIURIS CALCAREUM. 



the head, a sensation as if a nail were driven into 
the brain ; the clavus hystericus. (Ignatia, Thuja.) 

Then, on rising from stooping or on moving, 
and especially after walking in the open air, a 
stitching pain ; likewise on coughing. 

Boring pains in the temples and a boring ach- 
ing at the root of the nose, worse from moving 
the eyes. The forehead and scalp are sore and 
tender. (Bryonia, Eupatorium, China.) 

The hair falls out in spots, leaving them bald. 
Papules and pustules form on the scalp and nape 
and are sore to the touch. Also on the forehead ; 
worse in warmth ; better in cold air. 

Eyes. Eyes and lids inflamed. Lids swollen, 
red and aching, worse on being touched. Noc- 
turnal agglutination ; much muco-pus ; obscured 
vision. Eruption on the eyelids and below them 
on the cheek. 

It is a valuable remedy in strumous ophthalmia 
and ulcer of the cornea, occurring with milk crust, 
etc., etc. 

Complexion. Yellowish, with blue rings around 
the eyes. Red cheeks by day, without heat or thirst; 
but in the afternoon and night, heat. Sometimes 
erysipelatous swelling and redness of the cheeks. 

Ears. External : hot, red and itching. Stitch- 
ing in the inner ear on blowing the nose. 

Roaring and noises, worse p. m. 

Nose. Boring aching at the root of the nose 
from seven to twelve a. m. Dorsum sore to the 
touch. Frequent epistaxis. Loss of smell. 



HEPAR SULPHURIS CALCAREUM. 283 

Mouth. Corner of the lips ulcerated and erup- 
tion on the lips, with heat ; also vesicles, etc., on 
the chin and neck, very sore to the touch. 

Gums. Swollen, and aching of the molar teeth 
as if pressed out ; painful on biting. Toothache 
occurs when eating ; drawing pain, worse in a 
warm room ; and on biting it becomes a jumping 
toothache. 

Throat. Very important symptoms. Stitching, 
as if a sliver of wood or a fish-bone were in the 
throat, occurring on swallowing, yawning, on tak- 
ing a deep inspiration, and on turning the head, 
extending into the ear. Even also in the exterior 
parts of the throat, as in the cervical muscles. 
Feeling of internal swelling and pressure, as if a 
plug of mucus or some other body had stuck in 
the throat and could be swallowed away. Scratch- 
ing, scraped feeling in the throat, increased when 
swallowing solid food. Constant desire to hawk 
out mucus, and much saliva from the mouth, like 
water-brash. 

Dig